Your patients already know how diet, exercise, lifestyle habits, and genetics all influence health. Despite their motivation, patients often still experience hunger and cravings. As a primary care provider, you can help.

How to Help 

Primary care providers have the benefit of established rapport, regular follow-up, and understanding of the patient and their medical history as one, said Tara Schmidt, the lead dietitian from the Mayo Clinic Diet at Mayo Clinic in Rochester, Minnesota. 

“This gives them the advantage to start the conversation about lifestyle, the various pathways to address excess weight, and provide referrals when necessary,” she said. “Patients come with so many questions about diet choices; we rely heavily on primary care providers to at least provide the basics to initiate positive change.”

Discuss How Food Choices Make a Difference 

The two catchwords to focus on to stay fuller, longer are fiber and protein. Be sure to prioritize this point with patients. It could also be helpful to illustrate how these nutrients impact hunger. You could present this example: “Imagine the GI tract having to break down proteins and high-fiber plants vs simple carbohydrates. It is going to take longer, meaning that food will stay in the stomach longer and delay that empty stomach, which can send a hunger signal to the brain,” said Schmidt.

“Protein has the highest satiety value when compared to fats and carbohydrates,” said Schmidt. 

Another way to boost your messaging is to speak in a relatable tone. 

“Remember that the stomach doesn’t count calories, it recognizes volume, so think about the concept of volumetrics,” said Schmidt. 

Ask your patient to consider how they can add bulk to a meal without significant calories. “This is usually fruits and veggies,” she emphasized. 

More Tips for Mindful Eating 

“Primary care doctors have more frequent interactions with their patients, which has the potential to establish greater rapport and provide multiple touchpoints for conversations about lifestyle changes,” said Caroline West Passerrello, EdD, RDN, LDN, a spokesperson for the Academy of Nutrition and Dietetics who’s a faculty member in the Future Education Model graduate program at the University of Pittsburgh in Pennsylvania.

These suggestions for healthy eating could prove beneficial for patients.

Build meals around protein. Make protein the anchor of a plate, it’s the nutrient that tells your brain you’re full and keeps hunger from circling back too soon. “Higher-protein meals amplify gut-brain fullness signals (PYY, GLP-1, CCK) and curb ghrelin, which can delay the return of hunger,” said Passerrello. “Suggest eggs, yogurt, tofu, beans, fish, or chicken.” She does caution that very high-protein intakes aren’t appropriate for everyone, like patients with specific kidney conditions.

Choose high-fiber, low-energy-density foods first. These foods take more space, slow digestion, and tell your brain you’re full, helping you eat less without even trying. “A simple nudge is to start meals with a salad and have a vegetable side,” said Passerrello. She also cautions that patients gradually add fiber and hydrate to avoid GI discomfort.

Prioritize solids over liquids because food structure matters. Solids and foods that require more chewing slow the pace of eating, prolong gastric emptying, and enhance satiety compared with liquid like whole fruit vs fruit juice, she said. But keeping in mind smoothies can be convenient but are usually less filling per calorie, she also said.

Explain the dynamics of metabolism to patients. Reminding your patients to emphasize the bigger picture regarding boosting metabolism is helpful to their long-term success. “What changes weight and health most is sustainable energy intake and expenditure, body composition, and behavior, said Passerrello. 

Keep meals balanced. If an individual is going to enjoy a carbohydrate-centric meal once in a while, that’s okay, said Schmidt. “Just brainstorm ways to add color, fiber, and protein,” she said. For example, add berries and chia seeds to morning oatmeal, or add veggies and lean protein to a pasta dish. 

Make snacks healthier. For snacks, reach for a protein and a produce: Greek yogurt with berries, an apple with a string cheese, or raw veggies dipped in cottage cheese. 

Eat dessert strategically. If a person is intent on a sweet treat, encourage to have it as part of that meal as opposed to on its own later. “When we have protein and fiber included in the meal, blood sugar won’t rise as high as if you had a dessert solo,” said Schmidt. “This can help prevent overeating and that quick rise and fall of blood sugar.”

Seeking professional guidance for a registered dietician can be another resource for patients. “Registered dietitians have the benefit of time,” said Schmidt. “As opposed to an appointment with a primary care provider who likely has multiple issues to tackle in a shorter appointment slot, dietitians get to just focus on nutritional counseling.” They also can expand on the primary care provider’s directives and take it a step further to offer personalized, evidence-based advice tailored to the patient.

Schmidt and Passerrello have disclosed no relevant financial relationships.