Nutritional Counseling Is an Essential Pillar of Obesity Management
June 25, 2025
Innovations in Diabetes & Metabolic Care | Summer 2025
As the treatment of obesity has evolved to include advancements in pharmacotherapy —particularly glucagon-like peptide-1 (GLP-1) receptors — evidence-based, comprehensive obesity medicine continues to prioritize nutritional and lifestyle modifications. A personalized approach to diet and exercise that customizes interventions for each patient is essential for long-term success.
"Everyone loses weight differently,” says Samantha Humpal, MS, RD, LD, a registered dietitian at the University Hospitals Diabetes & Metabolic Care Center. “The dietitian's role is to encourage diet and exercise as the foundation for positive lifestyle change.”
A recent update from the American College of Cardiology (ACC) recommends GLP-1s as first-line therapy because of their efficacy compared with lifestyle changes alone. The statement also emphasizes the importance of a multidisciplinary care team in optimizing patient management.
Medical weight loss specialists at the UH Diabetes & Metabolic Care Center — including endocrinologists, advanced practice providers, dietitians, behavioral health specialists and clinical pharmacists — collaborate to provide patients with expert care that helps them achieve their personal goals. “Working alongside an interdisciplinary team gives us a variety of tools in our toolkit to tailor an individualized plan for each patient,” Humpal says.
Rather than a rigid diet, Humpal helps individuals focus on achievable changes that account for their comorbidities, personal preferences and time or financial limitations. “We often talk about the MyPlate model, which is an excellent visual guide for balancing protein with healthy fats and carbohydrates,” she says. “We also help patients understand the benefits of combining protein and fiber because this is what helps slow digestion to feel fuller longer and helps with glucose management, which can reduce snacking that can lead to a calorie surplus.”
Flexible Care Model
Patients enrolled in the weight-loss program at the UH Diabetes & Metabolic Care Center interact with multiple specialists during shared medical appointments. They also have the opportunity to participate in 90-minute monthly group classes, where they can share what is working for them or where they are facing challenges.
Humpal prefers to meet in person for patients’ initial visits and schedules follow-ups based on their goals and availability. “Implementing a lifestyle change takes time, so I usually like to touch base every four to six weeks,” she says. “We ask people to bring plenty of questions to troubleshoot any challenges or weight plateaus.”
Virtual visits offer an alternative for support if they are more convenient for patients.
Mediterranean Diet
“Through our program, we have developed a spiral-bound book that each patient receives, introducing the Mediterranean diet and breaking down the food groups,” Humpal says. The resource also includes a five-day meal plan, recipes and examples of strength and resistance training.
“We frame a lot of our discussions around the Mediterranean diet because it incorporates the healthiest foods in each food group,” Humpal says. “This is not a fad diet, but a well-researched way of eating that can be maintained as part of a healthy lifestyle.”
Highlights of the diet include unlimited non-starchy vegetables that are rich in vitamins, minerals and fiber while being lower in calories, along with lean proteins, low-fat dairy, whole grains and healthier unsaturated fats.
SMART Goals
Team members utilize the SMART goals framework to help patients achieve success by setting objectives that are specific, measurable, achievable, relevant and time-bound. “We want to meet patients where they are,” Humpal says. “For example, if an individual completes a diet recall, I might notice two cans of soda per day. Something that might be achievable or realistic would be to suggest swapping just one of those cans of soda for water over the next couple of weeks instead of eliminating soda entirely.”
Tailored Intervention
Humpal takes numerous factors into account when recommending dietary interventions. Along with calculating an individual’s unique calorie, protein and fiber targets, she poses questions to address potential barriers. “Are there cultural preferences, financial burdens or food aversions?” she asks. “Sometimes, we have to be a bit creative and think outside of the box. I think of food as a puzzle and strategize the best way to come up with a plan that a patient is comfortable with when we are trying to achieve a calorie deficit for weight loss.”
Interdisciplinary Collaboration
Working as part of University Hospitals’ multidisciplinary endocrinology team provides a seamless care model, Humpal says. “We are able to communicate very efficiently. If I meet with a patient who reports that they are doing more snacking or feel their appetite is not as suppressed, I can make a referral to the physician or our clinical pharmacist to consider a medication dosage adjustment. If staying on track is a struggle, I can refer patients to our behavioral health specialist because building healthy habits is crucial along this journey to better health.”
For more information, call the UH Diabetes & Metabolic Care Center at 216-435-1071.
Contributing Expert:
Samantha Humpal, MS, RD, LD
Registered Dietician
University Hospitals Diabetes & Metabolic Care Center
University Hospitals Cleveland Medical Center