How can a medical doctor influence eating habits?

Addressing the changes to be made

As starting basis, physicians interview the patients about their current diet to identify which dietary modifications have to be undertaken.

The goal is to address deficits in people’s understanding and knowledge of the long-term consequences of their eating behaviour on their health. Individuals’ intention and thus the willingness to invest energy and resources to modify the dietary behaviour should be addressed.

Raising awareness on the effects of nutrition

Medical doctors can have a substantial impact in raising awareness about the promising effects of nutrition on people’s health. Hereby, physicians rely on high-quality evidence-based information that they provide for those at risk or already affected by some condition of disease.

Avoiding overwhelm

It is key to avoid overwhelming patients with data but instead condensing complex information and building on incremental strategies (i.e., the why, what, and how) that individuals can implement in their daily life.

It is also important to keep in mind that for specific nutrition-related problems and questions the patients should be referred to certified dieticians in order to get the best possible support.

Realistic goal setting

Together with the patient, physicians work out specified, well-defined but also manageable steps towards clear goals. The more concrete the plans are (i.e., specified context, frequency, duration, and intensity), the higher is the likelihood that the healthy dietary behaviour can be sustained in the long-term (see implementation intentions Gollwitzer, 1999): “Whenever situation X arises, I will initiate goal-directed action Y”.

Healthy and easy meal options

For example, one could talk about a healthy and easy to prepare meal option that is likely to be enjoyed by the patient whenever cravings for chocolate arise. Anti-craving strategies reflect a way to combat bad habits and to come back on track after handling mistakes.

Linking options with positively connotated cues (e.g., tasty, fresh, and affordable food) removes the barrier of wrongful associations, such as that healthy food cannot be enjoyable and reduces the fear of losing joyful moments during mealtime.

Follow up and feedback

Part of behavioural counselling by physicians is to follow up on the patients’ health trajectory. This allows to track health parameters (i.e., weight loss and maintenance, improved levels of HbA1c) after introducing new dietary patterns.

Moreover, being in touch with their medical doctors on a regular basis boosts individuals’ motivation to stick to their new eating habits and reduces the risk of relapse.

Cascade effect

The socio-cultural environment is a decisive component of the process of changing daily habits. Physicians themselves can act as role models, whose dietary advice is only convincing to the extent to which it is implemented in their own lifestyle.

Their dietary behaviour serves as an observable sample of behaviour for people to imitate or to aspire to. It can have knock-on effects on patients, colleagues, and their communities.

Self-efficacy

Ideally, the physician can enhance people’s sense of self-efficacy with regards to the causal relationship between their daily eating habits and their physical and mental health.

Making the patient aware of the positive consequences of the desired diet and as well negative results of an undesired diet stimulates goal-oriented actions. The medical doctor for instance could encourage individuals to picture concrete mental imagery of two different versions of their future self.

Long-term nutritional lifestyle changes

In the imagined positive version of their future, they engage in long-term nutritional lifestyle changes, whereby their symptoms are relieved or even reversed. In the imagined negative version of their future, they maintain unhealthy eating habits and hence foster the disease progression or the development of comorbidities which induces anticipated regret.

This exercise is linked to moving towards desired and away from undesired goals and hereby supports the successful change of the patient’s eating habits.

Author: Dr. Sascha Venturelli