1. Stimulate patient awareness of and interest in diet, nutrition, and diabetes by explaining, in simple terminology, relationship between disease control and complications, rationale of treatment, and impact of social and environmental factors.

6. Encourage patient to become interested in daily, consistent exercise, new activities, and activities involving other people. Convince patient to deemphasize events revolving around food.

2. Develop good rapport and satisfactory relationship with patient. Be empathetic and compassionate but firm.

7. Encourage patient to deal with emotions (guilt, boredom, anxiety, anger, depression, self-pity, happiness) in ways other than excessive eating or binging.

3. Make patient aware of goals of therapy. Allow patient to set only achievable goals, since setting of unrealistic goals inevitably leads to failure and discouragement. Encourage patient to recover from binges and setbacks and to try again. Ascertain patient’s interest in order to provide new motivation and encouragement and set new goals. Ask questions that stimulate curiosity and general discussion; avoid questions that may be answered with “yes” or “no”.

8. Promote use of variety of foods and recipes to prevent boredom with diet.

9. Encourage patient to increase intake of bulk and fiber in diet, which may deter snacking. Incorporate raw foods, clear hot soups, and low-calorie beverages into diet to increase feeling of satiety. Encourage patient to eat slowly.

4. Continually encourage patient to assume responsibility for himself or herself. Refute excuses for noncompliance.

10. Institute gradual changes in diet plan to improve adaptability in noncompliant patient.

5. Encourage patient to record daily food intake and weekly weight measurement. Evaluate records with patient.

11. Institute behavior modification if necessary.