- freely available
Int. J. Environ. Res. Public Health 2009, 6(10), 2608-2622; doi:10.3390/ijerph6102608
2.1. The LMP Components
2.2. Study Participants
2.3. Procedures and Data Analysis
3.1. Participant Characteristics
3.2. Perceived Impact of the LMP on Health and Satiety
The LMP seems to be healthier compared to the treatment by the weight reducing machines. Some of my friends showed weight rebound after stopping the treatment by the weight reducing machines(No. 14:34).
Very healthy...throughout the LMP, you do not need to worry about any side effects and it is very healthy(No. 16:27).
Surely I have lost weight and become thinner. My health is better now, at least my eye is less swollen and my joints are less painful than before(No. 23:26).
After joining the LMP for three months, my weight has decreased from 70 kilograms to 60 kilograms and the blood cholesterol level has returned to normal(No. 20:32).
As for weight loss, I suppose the diet plan does not allow you to eat fully. But it is not the case for the LMP. I do not understand its rationale. Following the LMP diet plan makes me feel full and I do not feel hungry(No. 14:40).
I was surprised by the feeling of fullness experienced at the beginning of the LMP. I did not think that I ate less, but meanwhile I was able to lose weight gradually(No. 22:24).
3.3. Perceived Impact of the LMP on Nutrition Knowledge and Self-Control of Food Intake
In the past, I could not identify the healthy choices. I had no doubt that vegetables were healthy, so I ate vegetables regardless of the cooking methods. I also thought that vegetarian dishes were healthy, so I ate all kinds of vegetarian dishes. But now, I realize that there are many misconceptions. I know how to avoid such misconceptions and make healthy choices(No. 24:50).
For example, I will try to choose less oily food. In the restaurant, I will try to avoid foods with sauce or I will choose foods with less fat(No. 9:26).
I know how to choose the right foods now. In the past, although I knew that some foods might make me gain weight, I could not resist them. But now, I can resist them(No. 17:28).
Apart from weigh loss, I now pay more attention to my general health. I know that losing weight could help me lower cholesterol level and body fat, which are important for long term health(No. 24:68).
3.4. Perceived Barriers to Change – Psychological Factors
In the LMP, you occasionally experienced a cycle of weight loss and rebound, which made you very upset. I asked myself why there was a weight rebound and felt very frustrated. Also, when you joined the LMP for a certain period, you became less self-disciplined(No. 14:54).
I felt bored sometimes. Just imagine if you ate similar foods everyday, it was really a boring and hard process(No. 18:68).
Sometimes, I was frustrated because my weight remained the same for such a long treatment period. At that moment, you started to doubt your own ability to succeed and your nutritionist’s ability to provide an effective intervention(No. 18:64).
The most difficult thing comes from eating out with friends or colleagues. Each time when I see the nutritionist, I feel a bit stressful. I am afraid of weight rebound and not achieving the dietary goals. So I feel a bit stressful whenever I eat out with my friends or colleagues(No. 11:42).
If all your friends choose a restaurant which you know you cannot find any healthy choices, it is difficult for you to reject their decision. You may reject occasionally but not always(No. 18:116).
When you eat out with friends or colleagues and you restrict yourself to eating certain food choices, they will say “Oh no...not again!”(No. 18:68).
I have low self-discipline. I need my family members and friends to remind me to self monitor. They can eat whatever they want, but they must keep those foods out of my sights(No. 4:50).
3.5. Perceived Barriers to Change – Environmental Factors
I tried to prepare noodles at home and bring it to my office. A refrigerator was however not available in my office, the noodles were easily spoiled at room temperature(No. 22:32).
For me, it is not difficult to follow the diet plan. However, it is difficult to find time to do more exercise due to busy work(No. 21:36).
The restaurants near my workplace offer limited healthy choices. Most dishes are served with unhealthy sauces and most are fried foods. I definitely cannot find any good choices. So I cannot follow the diet plan perfectly(No. 19:32).
It’s difficult to find healthy choices in Hong Kong restaurants. If you want to have healthy choices, you often need to have meals at home or bring your home-made healthy dishes to the workplace. It is quite difficult to arrange sometimes(No. 15:66).
Once if you go to a banquet or go travelling, you cannot follow the diet plan(No. 9:24).
3.6. Client’s Perceptions of Nutritionist’s Roles in the LMP
If the nutritionist can provide some sorts of emotional counseling, ask me more about my feelings or difficulties, this would be better(No. 25:108).
If the nutritionist has more understanding of your thoughts and difficulties and she/he is able to help you solve such difficulties, it will be better than just giving you a menu and asking you to follow(No. 14:62).
3.6.1. Nutritionist being an information source in the LMP
For some special events, my nutritionist will adjust my diet plan and give me some special tips. For example, in case of hot pot meal (Chinese style of Fondue), she teaches me to eat vegetables first to give me feeling of fullness. So I know how to choose foods in special events(No. 6:88).
The diet advice taught by my nutritionist is practical and clear. For example, the size of the forefinger plus the middle finger is similar to one portion of meat, and one medium bowl of rice contains three portions of carbohydrates. So these examples are easy to be applied in my daily life(No. 8:138).
If I cannot follow the diet plan, my nutritionist will encourage me and set some easier goals for me to achieve(No. 5:62).
During the LMP, my nutritionist offered me flexibility in eating snacks. She wouldn’t advise me to stop eating all snacks. Instead, she allowed me to reduce snack consumption gradually. This made me feel better(No. 19:44).
My nutritionist is willing to discuss new products with me. She will ask me to bring them back in the next appointment and explore what they are. She is willing to accept new things(No. 14: 126).
3.6.2. Nutritionist being a psychological supporter in the LMP
Sometimes I cannot follow the diet plan, she (the nutritionist) would not give me any negative comments. Instead, she would explain to me that the weight loss would be smaller than expected(No. 17:48).
If I was unable to follow the diet plan, she (the nutritionist) would adjust the diet plan based on my job nature, my personality and my recent status. She would not say something negative or discouraging to me. She instead showed her understanding and this made me feel better and encouraging(No. 5:80).
When my weight cannot meet the targeted weight, she (the nutritionist) would kindly ask me if I had any difficulties in following the diet plan(No. 8:124).
She (the nutritionist) would comfort me when I felt frustrated because of not achieving the weight loss target. She (the nutritionist) would explain the reason to me and encourage me(No. 14:68).
She (the nutritionist) would talk with me on my school life and daily life(No. 4:78).
We share as friends. I sometimes share my unhappiness with her (the nutritionist). She will comfort me. It’s more important than just giving you diet menu(No. 14:74).
3.7. Improvements for the LMP
I have around ten minutes for each consultation. When I have some questions on diet, I need to ask these questions hurriedly within the ten minutes’ time. If the consultation time is longer, it would be better(No. 19:46).
I think different nutritionists have different working and presentation styles. Nutritionist A is more active in explaining the diet plan to me whereas nutritionist B is relatively passive. She will only explain more to you if you ask her(No. 15:78).
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|Below 20 years||1||4|
|40 + years||15||60|
|Duration since joining the LMP|
|Less than 6 months||16||64|
|Between 6 and 12 months||3||12|
|More than 12 months||6||24|
|Tried to lose weight before|
|BMI at the start of LMP1|
|BMI at the time of interview1|
|1. Perceived impact of the LMP|
|2. Perceived barriers to change|
|3. Client’s perceptions of nutritionist’s roles in the LMP|
|4. Improvements for the LMP|
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