Frequently Asked Questions

Do you have addtional questions about nutritional counseling? If so, the following FAQs may help you out.

Q: How long does nutritional counseling take?
It varies with the problem you are trying to change. Research has shown that 3-4 visits with a registered dietitian are needed for optimal lowering of cholesterol levels. Similar recommendations exist for those with diabetes along with the addition of an annual check of progress. For weight loss, weekly or bi-weekly follow up for the first 6 sessions with continued follow up at bi-weekly or monthly intervals improves success.

Q: Is nutritional counseling covered by health insurance?
Health insurance plans vary widely in whether they cover nutritional counseling and for which conditions they cover nutritional counseling. It even varies from plan to plan within a particular health insurance company. Your best approach is to call them and ask. Tell them what you are looking for and any related health conditions that would be impacted by changing your eating habits. Nutritional counseling is not the only thing you do for your health that isn’t covered by health insurance. Joining a gym or taking a multivitamin usually isn’t covered either. But meeting with an expert to develop an individualized behavior change plan then receiving help implementing it is well worth the cost (see link to prices ).

Q:What results can I expect with nutritional counseling?
Lifestyle changes can decrease LDL (bad) cholesterol by 25-30%, which is enough for some and will decrease the amount of cholesterol lowering medication needed for others (decreases cost of medication and the chance of medication side effects). Initially, a decrease of 1% in your HgbA1c can be expected for diabetes. For high blood pressure, a change in diet and lifestyle can be as effective as adding a medication. Permanent weight loss is the goal for losing weight. I applaud the success of 5-10% weight losses since this is associated with changes in health and well-being. A 10% weight loss in 6 months is reasonable, but results vary widely. People who are heavier to begin with or are male tend to lose weight faster than those who aren’t quite so heavy or are female. We continue to monitor how you are doing and evaluate when the effort of continuing to lose weight is too great to continue at that time. Then, we switch to maintenance of weight loss as the focus for a period of time similar to the time you spent losing weight. When you are ready again, we can re-institute the weight loss phase.

Q:What about nutritional supplements? Do you recommend a particular kind?
I may recommend a particular type of nutritional supplement for different clients depending on their needs. For others, I may evaluate the supplements they are currently taking in comparison with their needs. I do not recommend particular brands and I don’t sell supplements.

Q:Won’t my child just grow into his or her weight?
It depends on how old the child is, how long he/she has been overweight, and how heavy he/she is. In general, the older a child is, the longer they have been overweight, and the heavier they are, the more likely that their overweight will persist into adolescence and adulthood. Some children will grow into their weight but many others will not without intervening in some way. A SHAPEDOWN assessment will help you decide whether growing out of a weight problem is likely or not for your child. If you do decide to take action, the SHAPEDOWN program is a safe way to do it that protects your child’s growth and does not put them on the diet roller coaster for the rest of their life.

Q: At what age can children participate in the SHAPEDOWN program?
The SHAPEDOWN program is designed for children 6 to 18 years of age. The workbooks are age-graded to 6-8 years, 9-10 years, 11-13 years, and 14-18 years. The youngest workbook incorporates more fantasy in the stories while the others have stories about children having familiar experiences and similar in age to SHAPEDOWN participants.

Q: My child is under age 6, will the SHAPEDOWN program help him or her?
Parents have almost total environmental control for a child under age 6. For this reason, parents are the focus of change for very young children. What I do is conduct a pediatric nutritional assessment with the parents and the child, then address my recommendations and plans to the parents only. Once a child enters elementary school, they do have some measure of control over their own food intake and physical activity. This is also the time when self-esteem issues might start to emerge from childhood teasing. This is when the SHAPEDOWN program can be helpful in showing a child what they can do and that their parents are right there to help them and accept them no matter which way their body grows.

Q: I don’t want to deprive my other (thin) child. Can we just institute changes for my overweight child?
Eating healthy and being physically active is healthy for everyone. That is why the SHAPEDOWN program emphasizes family change, not individual child change. Parents and siblings all benefit from living healthier. The SHAPEDOWN motto is to “eat light, not depriving.” Extras like cookies or chips are okay for anyone on occasion, even those with weight problems; but eating them all day long and neglecting the healthy main meals won’t do anyone any good. A thin, active sibling may need to eat more and larger servings at meals and snacks to get enough calories but they don’t need to eat different kinds of food. Remember, the emphasis is on living healthy, not changing a particular family member’s weight.

Q: Will all this emphasis on weight increase the chance that my child will develop an eating disorder?
Follow up research done with family-based weight control programs for children have shown no increase in eating disorders among the participants. In fact, a treatment that emphasizes healthy eating and activity habits may inoculate a child against an eating disorder. Also, the SHAPEDOWN program encourages parents and children to talk about feelings and teaches them to work together to solve problems. This can help a child dealing with distress that could lead to an eating disorder by providing them with options other than eating disordered behavior.

Q: How much time does the SHAPEDOWN program take each week?
You need to plan on about an hour each week for the weekly session in my office as well as 10 minutes per day of family time to review your records together. Recordkeeping, reading, and family activities will take another 2-3 hours per week. Once you complete SHAPEDOWN, you will want to continue regular family activities as part of your new healthy lifestyle.


Janet Mann Nutrition Consulting