In this episode, Nate and Justin discuss the powerful technique of motivational interviewing to figure out how to help Tina inch closer towards her own goals.

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=== Outline ===
1. Introduction
2. Chapter 1: Taking a Dietary History
3. Chapter 2: Motivational Interviewing
4. Conclusion

=== Learning Points ===

1. Changes in food habits and eating patterns can mean breaking patterns that have been ingrained over lifetimes
2. Fear and shame are not effective motivators, and so should not be used to persuade patients to change behaviors. Instead, emphasize the positive benefits that are present in the short term.
3. Taking a detailed hour-by-hour dietary history can uncover additional opportunities to change eating patterns. Be sure to ask patients how they prepare foods, dress foods with condiments, and so forth.
4. Empowering patients and removing judgment is critical. Motivational interviewing is a technique that frames change in an actionable, self-empowering manner, while uncovering reasons for changing eating patterns that are not solely weight-centered.
5. In addition to achieving weight loss goals, changing nutrition is an opportunity to help patients get excited about other health goals, such as improving their blood pressure or reducing their risk of developing diabetes.

=== Our Expert(s) ===

Dr. Justin Charles is a graduate of the Yale Primary Care Internal Medicine Residency Program.

His clinical interests are in Lifestyle Medicine, the use of evidence-based lifestyle interventions to not only prevent, but treat and reverse chronic disease from a root cause perspective. He has received training in Plant-Based Nutrition through the T. Colin Campbell Center for Nutrition Studies and eCornell, as well as Dr. John McDougall's Starch Solution Certification Course. 

=== References ===

Arab L, Tseng CH, Ang A, Jardack P. Validity of a multipass, web-based, 24-hour self-administered recall for assessment of total energy intake in blacks and whites. Am J Epidemiol. 2011 Dec 1;174(11):1256-65. doi: 10.1093/aje/kwr224. Epub 2011 Oct 20. PMID: 22021561; PMCID: PMC3224251.

=== Recommended Reading ===

1. Moshfegh, A.J., Rhodes, D.G., Baer, D.J., Murayi, T., Clemens, J.C., Rumpler, W.V., Paul, D.R., Sebastian, R.S., Kuczynski, K.J., Ingwersen, L.A., Staples, R.C., Cleveland, L.E. The US Department of Agriculture Automated Multiple-Pass Method reduces bias in the collection of energy intakes. A J Clin Nutr. 2008;88:32 4-332
2. Johnston CA, Stevens BE. Motivational Interviewing in the Health Care Setting. Am J Lifestyle Med. 2013;7(4):246-249. doi:10.1177/1559827613485923
3. Hauser ME, McMacken M, Lim A, Shetty P. Nutrition—An Evidence-Based, Practical Approach to Chronic Disease Prevention and Treatment. Fam Pract. 2022;71((1 Suppl Lifestyle)). doi:10.12788/jfp.0292

*For more reading recommendations, check out our transcript!

=== About Us ===

The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible and informative podcasts about core primary care topics centered around real patient stories.

Hosts: Nate Wood
Producers: Nate Wood, Helen Cai, August Allocco
Logo and name: Eva Zimmerman
Theme music and Editing: Josh Onyango
Other background music: Patrick Patrikios, pATCHES, Myuu, VYEN, Reed Mathis, 

Instagram: @pcpearls
Twitter: @PCarePearls
Listen on most podcast platforms: linktr.ee/pcpearls