Dietary therapy begins by conducting a thorough dietary assessment of the patient starting with evaluation of readiness and motivation to make dietary changes. It is generally accepted that the cause of obesity is multifactorial, brought about by an interaction between predisposing genetic and metabolic factors and a rapidly changing environment. Dietary therapy, exercise counseling, and behavioral change are the principal interventions of lifestyle modification. A weight history is best appreciated and understood by asking the patient to graph his or her weight as it relates to life events. Although a diet recall provides a glimpse into a typical day, many patients consume majority of extra calories on weekends or during out of town trips. Although both the dietary recall and food log methods for dietary assessment are biased by under-reporting, they are extremely useful for identifying diet and lifestyle patterns.
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