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Counseling Overweight Adults: the Lifestyle Patterns Approach and Toolkit

Pattern recognition, also known as heuristics or intuitive thinking, is an innovative approach to counseling.2 Pattern recognition is familiar to diabetes clinicians when reviewing the relationship between a patient’s blood glucose, meals, and medication administration. Adjustments in meals and medications are made after reviewing a patient’s blood glucose patterns. For obesity care, diet, physical activity, and behavioral counseling are adjusted based on a patient’s lifestyle patterns. This is the basic premise underlying this new counseling method. Figure 1 depicts a lifestyle patterns organizational chart showing the seven lifestyle patterns in each of these three dimensions.3

These 21 patterns were developed intuitively after treating thousands of overweight patients during the past 25 years. By taking a previously validated 50-item questionnaire, patients find out, for example, if their eating pattern is that of a Meal Skipper, a Convenient Diner, or a Hearty Portioner; if their exercise pattern is that of a Couch Champion, an All-or-Nothing Doer, or an Uneasy Participant; and if their coping pattern is that of a People Pleaser, a Fast Pacer, or an Overreaching Achiever.4 The qualitative lifestyle pattern names help clinicians connect quickly with patients. “You pegged me,” is a frequent comment clinicians hear when using this approach. And feeling understood is often the springboard for an empathetic and therapeutic clinician-patient relationship.