• Changing dietary emphasis e.g. more fibre, less fat, spreading meals
• Reducing triggers, e.g. different route to work, change time of eating, place meal is taken
• Re-emphasise health risks & relative risks
• Personalise diet plans
• Re-run motivation questionnaire, try to identify stumbling blocks
• Check medication ( certain drugs can precipitate weight gain e.g. gliclazide)
• Re-check co-morbidity i.e. diabetes, CHD, heart failure, COPD, thyroid disease, hypertension, depression
• Consider anti-obesity drugs if not used before
• Enlist specialist dietetic support. Check times of clinic are suitable for the client
• Enlist help of support groups i.e. family support, ‘buddy system’, commercial slimming groups
• Identify any problems with exercise- FITT programme, walk for life etc
• Make goals SMART!!
• Consider client choice

If patients are gaining weight or have increased co-morbidity

• Enlist help of specialist weight management clinics
• Consider surgery
• Give clients the opportunity to re-enter the programme at any time. 

Great patient leaflets to consider using:

• So you want to lose weight for good? – British Heart Foundation/Faculty of Public Health Obesity Toolkit
• Getting the balance right – British Meat Education Service
• Patient resources & leaflets – DOM UK