Guidance for Addressing Client Concerns
“I am worried that I will gain weight.”
Explore where the worry is coming from. Determine existing knowledge.
- What do you know, or what have you heard about quitting smoking and weight gain?
- Can you tell me more about why you are feeling worried about gaining weight?
- Can we chat more about this? I have some information that might be helpful if you are okay with me sharing it.
Provide information (not too much). Consider what the client really wants to know.
- Any one person may lose, gain, or stay the same weight when quitting smoking.
- For people who gain weight, on average this ranges from 5-12 lbs.
Discuss how the health benefits of quitting smoking outweigh risks associated with weight gain.
- Weight is not a good predictor of overall health.
Allow client to express how they feel about the information you provide.
- What do you think about the information I shared?
- Do you have any questions about this information? Is there anything else you’d like to know?
Elicit change talk, revisit the client’s reasons to quit smoking.
- Earlier you mentioned a few very important reasons for quitting smoking including ‘X’.
- How are you feeling about your concerns with weight gain now since we have talked about it?
“Another HCP advised me to watch my weight because of ‘X’ (injury, blood pressure, etc.) and I’ve been eating a lot more junk food since quitting” OR
“I am gaining weight and I can’t do any physical activity right now because of ‘X’ (trouble breathing, recent surgery, recovering from injury, etc.)”
Weight does not dictate health. It can be helpful to focus on behaviours that support our health and well-being rather than focusing on weight.
Discuss reasons for appetite changes and food cravings.
Allow client to express how they feel about the information you provide
- How do you feel about the information I just shared?
Discuss strategies for managing cravings to smoke, based on the triggers to smoke that the client has identified.
Ask client if they’d like information on dietitian services available.
“I am happy that I’ve quit smoking, but I’ve really started to gain weight and I don’t want to.” OR “I find that I am eating a lot of ‘X’.” OR “I’ve tried to substitute with healthy snacks, but I still crave the unhealthy snacks, and then I just end up eating double.”
Discuss possible reasons for appetite changes. Provide information. Elicit the client’s response to what you have said.
- What do you think about what I just shared?
- Is there anything else you’d like to know?
Discuss how client’s eating pattern is supporting quitting smoking and coping.
Ask if client would like to talk about their eating.
- Can you tell me about what your day looks like, when it comes to eating (e.g., consistent eating pattern or not, sitting down to eat, paying attention while eating)?
- Are there times where you aren’t eating enough (e.g., skipping meals, not eating snacks, choosing low calorie foods)?
- Would you like to talk about listening to your body and following hunger cues?
Enjoyment and satisfaction is an important part of eating well.
- When you are grabbing a snack, could you ask yourself: Am I hungry? What am I feeling? How can I choose foods that make me feel good (sometimes that might be comfort foods; sometimes that might be more nutritious foods)?
Discuss other strategies to manage cravings. It’s normal to eat for reasons other than hunger.
- What other coping skills do you have? Would you like to talk about practicing something new?
- If you aren’t hungry, but are looking for something to enjoy, what are some things you could try doing to manage a craving (e.g., physical activity, art, breathing exercises, etc.)?
Resources
Refer client to, or encourage seeking out a registered dietitian or mental health professional, if the client is struggling with eating.
- Family Health Team
- Community Health Centre
- Community Mental Health Services
- Hospital/Diabetes Education Centre
- Private Practice (fee for service)
Telehealth Ontario at 1-866-797-0000 or TTY: 1-866-797-0007 (press 2 to be directed to a dietitian).
