Patient
DB

Height: 5 ft 8 in

Weight: 196 lbs

BMI: 29.8

Registered Dietitian

Tegan Bissell, RD

Insurances: Aetna,Anthem,Blue Cross Blue Shield,Cigna,United Healthcare

Diagnosis and Treatment Plan

Diagnosis:

Client presents with food and nutrition knowledge deficit related to diet for prediabetes and weight loss as evidenced by A1c of 5.9 and inability to lose weight through own interventions.

Today client states he has gained weight (2 lbs since last visit). Reports more exercise now, doing FitBit workout videos consistently. States the increase in physical activity is making him hungrier. Has been snacking in the middle of the night when taking the dog out. Discussed increasing foods to promote satiety, specifically protein, hydration and fiber. He will purchase the optimum protein powder which he has used in the past and drink with breakfast or on the way to work. Brainstormed ideas to avoid eating at night. Encouraged tuning into physical vs mental hunger, (admits he is physically hungry only 30% of the time) and having healthy options available in his fridge, or just sipping water at that time. admits he still needs to drink more water.

Nutrition Interventions:

Reviewed: plate method, general healthy eating, sources of protein, sources of non-starchy vegetables, sources of carbohydrates, sources of healthy fats, label reading, meal planning, whole vs processed foods, red and processed meat recommendations, beverage choices and hydration, snacking, brainstormed meal and snack ideas, effects of stress and sleep deprivation on weight management, exercise benefits of resistance exercise, importance of adequate sleep, tracking and apps/programs to use, vitamin D, hyperlipidemia, getting spouse on the same page, protein drinks, popcorn flavorings, healthier snack ideas, counting calories, hydration, building goals into the day/attaching a goal to something we already do, hunger/fullness scale, meal timing, exercise planning, physical vs emotional hunger, practice/building lifestyle habits rather than pass/fail mentality, mindful eating, fiber and gut changes, self talk, breaking habits, protein needs

Readiness to change dietary habits: 8/9

Nutrition Monitoring and Evaluation:

Goals:

  1. Include a breakfast daily. Eat in place of second cup of coffee. Add protein drink, additional egg or protein on toast.
  2. Use popcorn as a snack.
  3. Drink more water. Start with 1 cup at breakfast, 8 oz when doing timesheet at work, finish water bottle before end of workday, and another 8 oz with dinner.
  4. Focus on hunger and fullness and slow down eating. Check in to see if he is physically or mentally hungry.
  5. Work out after work doing Fitbit Videos. Avoid drinking beer when getting home until after dinner.
  6. Prep veggies and hummus and choose this or water in middle of the night if physically hungry.

All questions were answered throughout our session. Client denies any questions or concerns but was encouraged to call if they arise.

Emailed client written materials to reinforce nutrition education: none

Follow up appointment was scheduled for 4 weeks with this RD.


Topics Discussed

Weight Loss

Appointment History

Number of Sessions: 4

Last Updated: May 11, 2024