Loading ...

Many of your patients are arduously shifting their diet habits, boosting exercise, and making lifestyle tweaks to shed pounds. Even with these actions in place, they may not be losing weight. During your discussions, they may express their frustration regarding how they are trying their best but not reaching weight loss goals. One culprit that could be standing in the way for your patients is sneaky liquid calories. It’s important to discuss how excess liquid calories could be sabotaging well-intentioned patients. Here’s how to start the conversation and what to suggest.

Help Set Attainable Goals

Practical advice is the first approach, and this should include a discussion about healthy eating habits and incorporating exercise. In addition, a discussion about setting attainable goals should be addressed.

“Make sure that the roadblock is not because of unrealistic expectations,” said Elisabetta Politi, a registered dietician and certified diabetes educator at the Duke Lifestyle and Weight Management Center in Durham, North Carolina. “If this is the case, I help them set more attainable goals, encouraging them to continue their journey while emphasizing the importance of a comprehensive approach.”

Why Liquid Calories Could Cause a Weight-Loss Plateau

Even with the best intentions, your patients may not recognize or realize how liquid calories in their diet could be sabotaging their weight loss goals. This can result from misinformation, as well as failing to understand how some drinks are high-caloric. It can be helpful to point out these liquid calories to patients:

Fruity drinks: Even if some boast vitamin C or other nutrients, their effect on weight loss should be called out. “Although they don’t satisfy hunger, they are lower in fiber than fruits and high in sugar — watch especially the added sugar,” Politi said.

Coffee drinks: Despite the health benefits of coffee, knowing the ancillary effects is important for patients to understand. “The combination of sugar, caffeine, and cream can be a powerful appetite enhancer,” Politi said. In fact, your patients may not realize the fancy coffee they drink in the morning contains upwards of ≥ 50 g of added sugar. The American Heart Association suggests that we try to keep our intake of added sugar to a minimum, with a goal of ≤ 36 g for men and 24 g for women, said Amy Bragagnini, MS, RD, CSO, spokesperson for the Academy of Nutrition and Dietetics based in Grand Rapids, Michigan.

Alcohol: An occasional drink isn’t going to make or break a weight-loss plan, but a discussion about moderation is warranted. “Alcohol may affect commitment to health goals by lowering inhibition,” said Politi. “Besides, calories from alcohol are metabolized fast, which makes weight loss more challenging.”

Regular sodas: These picks present empty calories, excessive sugar, and no nutritional value, Politi added.

Smoothies: Refreshing and trendy, smoothies can go from protein winners to sneaky calorie culprits. “They can become calorie bombs, especially when mixed with fruits, sugary syrup, and ice cream or cream,” cautioned Politi.

Protein drinks: These can be tricky, so reading the label is vital. “It is one thing to have a little protein powder mixed with milk or water, but it’s an entirely other thing when one is choosing a ‘protein smoothie’ that is more like a milkshake than anything else. I would urge caution to anyone purchasing a protein smoothie topped with whipped cream and chocolate sprinkles,” said Bragagnini, with the Academy of Nutrition and Dietetics.

To assist your patients, discuss how these liquid calories could be hampering their goals. 

“To those (patients) who don’t seem to be interested in making changes, I point out that research has clearly shown that liquid calories are one of the main obstacles to weight loss, no matter the approach they are following,” Politi said. “In a weight loss world with several conflicting recommendations, abstaining and limiting liquid calories is an advice everyone agrees with.”

In her work with patients, she said many are curious to see if reducing liquid calories can help their weight loss journey. To springboard, it could be advisable to suggest scaling down sweetened drinks or diluting them with water or another unsweetened beverage.

Alternatives to Liquid Indulgences

The beverage industry has introduced alternatives to sweetened beverages, ranging from carbonated to flavored to infused water and drinks with beneficial prebiotics and probiotics, said Politi.

Discuss Chewable Alternatives to Liquid Calories

Bragagnini, with the Academy of Nutrition and Dietetics, discussed how “satiety” plays when we eat or drink certain things. “Take an orange, for example. It may take a while for you to fully peel, separate, and eat the orange, but it may only take a few seconds for you to drink a small glass of orange juice,” she said.

It may be effective to explain to patients how both options may deliver the same number of calories and natural sugar; the process of peeling and eating the orange will likely lead to you feeling more satisfied after consuming it, she said.

Special Considerations for Those With Diabetes

Sugar spikes are a cause for concern. Politi, with Duke Lifestyle and Weight Management Center, said this should be brought to the attention of patients with diabetes. “I tell patients with diabetes that one 12 oz can of regular soda contains as many as 10-11 tsp of sugar, which will be rapidly absorbed in their bloodstream, causing a rapid rise of their blood sugar,” she said.

It’s important to discuss blood sugar levels with patients. 

“Simple sugars are quickly digested and absorbed into the bloodstream, which can cause rapid increases in blood sugar levels. This can be dangerous for someone with diabetes, as it can lead to fluctuations in blood sugar and potentially damage nerves and blood vessels,” Bragagnini said. “I advise folks to begin checking both food and beverage labels and get familiar with how much added sugar is in the various products they choose.”