monitoring health status. Clinical programs should assess all clients for these risk factors.
Nonclinical and clinical programs should measure the height and weight of clients and calculate their BMI and WHR, providing both the results and the information to interpret those results. Do-it-yourself programs should encourage their clients to take these measurements and make these calculations, instruct them how to do so, and explain the results.
Clients in nonclinical and clinical programs should have their diets and physical activity patterns evaluated at least at the beginning and end of the treatment phase of the program and every 6 months during any maintenance phase (various assessment tools are described in Appendix A). Nonclinical programs should assess the psychological status of clients with a questionnaire such as the Dieting Readiness Test; clinical programs should use this type of questionnaire along with a second questionnaire such as the General Well-Being Schedule (both questionnaires are provided in Appendix B). Do-it-yourself programs should inform clients about the importance of attention to diet, physical activity, and psychological assessment (by providing the Dieting Readiness Test or a similar questionnaire), and give explicit guidance in how to do so.
Since no weight-loss attempt is risk free, it is incumbent on each program to inform potential clients about the known and hypothetical risks of that program. Clinical programs have special responsibilities to assess and manage potential risks, especially when special diets (e.g., very-low-calorie diets), drugs, or surgery are used as part of the treatment.
Given the limitations of do-it-yourself and nonclinical programs to assess health compared to clinical programs, consumers choosing the former have a greater responsibility for self-monitoring their health. Consumers should have a good understanding of the program of interest and what they can expect from it throughout the treatment and any maintenance phase. They should have access to information about the qualifications and training of staff in nonclinical and clinical programs and the credentials and qualifications of the author/originator of a do-it-yourself program.
Clients should expect that the program of interest will be a safe and sound one (by meeting our recommendations for them as detailed above). We recommend that they monitor their weight weekly and continue to assess (or have assessed) their diet and physical-activity patterns at 6-month