The Importance of Nutrition and Fitness Professionals in Weight Loss Weight Loss Maintenance and Body Recomposition
Walsham, James Marshall
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Rates of obesity have risen globally over the last 30 years, obesity is a risk factor for many diseases such as metabolic disease (which includes diabetes, dyslipidaemia, hypertension, and heart disease), leading to a globally increasing burden of disease. Obesity not only impacts the individuals who suffer from it, but society as a whole; it is estimated that 7-20% of all healthcare costs are directed towards preventing or managing the effects of obesity. Effective long-term nutritional care may be an important factor in mitigating the effects of the obesity epidemic, as regaining weight after dieting is typical when attempting weight loss autonomously or with usual care (from non-nutrition specialists without focus on the weight maintenance period). Indeed, comprehensive, multidisciplinary care during the weight maintenance phase leads to higher rates of bodyweight maintenance post dieting. Many different nutrition and fitness professionals work with weight loss management clients by providing exercise, behavioural, or nutrition guidance. However, there are no reviews assessing the scope of the literature on the effectiveness of different nutrition and fitness professional's weight loss management guidance. Therefore, the purpose of this dissertation was to conduct a scoping review to evaluate the current literature on the role and effectiveness of various health and fitness professionals in providing weight loss and weight loss maintenance guidance. Following PRISMA guidelines for scoping reviews, databases (PubMed, CINAHL, Scopus, Medline and SPORTDiscus) were searched for relevant articles using terms related to weight loss and various health and fitness profession titles, with no date restrictions. The search yielded 7815 unique articles, with 25 studies meeting the inclusion criteria. In sum, 37 total practitioner types were identified across the 25 studies, these practitioners were separated into groups: Registered Dietitians (RD) (n = 19), Nutritionists (n = 1), Exercise physiologists and physical therapists (n = 4), personal trainers (PT) (n = 3), health coaches (n = 4) and other health professionals (n = 5) and the literature was qualitatively assessed. It was found that most people who seek weight loss and weight loss maintenance don’t engage with RDs, who are often considered the most appropriate practitioner for this purpose. Rather, people may be more likely to engage with PTs, other fitness professionals, and the emerging profession of health coaches. There are no studies comparing the effectiveness of weight loss and weight maintenance guidance from different professionals. Therefore, more studies which evaluate health and fitness professionals’ capabilities in these roles which make comparisons between professions are needed to best inform practice, scope of practice, and multidisciplinary collaboration.