Supported Lifestyle Modification

Encourage Self-Motivation: 
Shift the conversation to focus on the patient’s reasons for wanting to change, rather than giving directives.

Summarize Key Points: Summarizing reinforces important aspects of the conversation and helps patients feel understood.

Rice isn’t the foe; it’s the way that we eat,
A half-plate shift, a smaller treat.
Mixed with greens and proteins lean,
A balanced bowl, a sight serene.

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Use Affirmations: 

Recognize and praise patients’ strengths and efforts to build confidence and motivation.

Express Empathy: 

Acknowledge patients’ feelings and concerns, making them feel respected and supported.

Practice Reflective Listening: 

Reflect back what patients say to show empathy and understanding, helping them feel heard.

Focus on Open-Ended Questions: 
Use questions that encourage patients to elaborate, rather than give simple yes/no answers.

Doctor: “What concerns you most about your health right now?”

Poems

…a common scene
…a different tweak
…rice are the victim?
…not with M.I technique

Dr. Sherly: [Smiling warmly] Good morning, Mr. Ahmad! How are you feeling today?

Mr. Ahmad: Morning, Doctor. I’ve been alright, but I keep thinking about this prediabetes diagnosis. It’s just a lot to process. Diabetes runs in my family, but I didn’t expect it to affect me.

Dr. Sherly: I can imagine. Learning about this diagnosis can feel overwhelming, especially when you weren’t expecting it. [Pauses] If you’re open to it, would you like to talk through what changes could help? I’d love to work together on a plan that feels manageable for you.

If you’re open to it, would you like to talk through what changes could help? I’d love to work together on a plan that feels manageable for you.

Mr. Ahmad: I think that would be helpful, yes. I just keep hearing that it’s because of rice—everyone around me says it’s the main problem. But rice is such a big part of our meals! I mean, do I really have to give it up?

Dr. Sherly: [Nods empathetically] That’s a really valid concern. I know rice is central to Malaysian meals and traditions, so giving it up can feel difficult. Let me ask, what are your thoughts on adjusting your intake, rather than eliminating it completely? Would that feel more doable?

Let me ask, what are your thoughts on adjusting your intake, rather than eliminating it completely? Would that feel more doable?

Mr. Ahmad: Hmm… maybe. But it’s just that people have eaten rice here forever, right? My grandparents ate it every day, and they didn’t have diabetes. So I’m not sure why it’s causing problems now.

Dr. Sherly: That’s a great observation, Mr. Ahmad. You’re absolutely right—our grandparents often ate rice with every meal, but their lifestyles were very different. They were very active, which helped their bodies process that extra energy. Nowadays, many of us spend more time sitting, whether it’s at work or in the car, which makes it easier for the body to store extra glucose from rice as fat.

That’s a great observation, Mr. Ahmad. You’re absolutely right—our grandparents often ate rice with every meal, but their lifestyles were very different.

Mr. Ahmad: I see… so it’s not that rice itself is “bad,” but maybe more about how much I’m eating and how active I am?

Dr. Sherly: [Smiling] Exactly. It sounds like you’re already thinking about it in a balanced way. If I may ask, how do you feel about the idea of just adjusting your rice portion a bit? Maybe you could try starting with a half portion and balancing it out with more vegetables or lean protein. Would you be open to that as a small first step?

Would you be open to that as a small first step?

Mr. Ahmad: [Pauses, thinking] You know, that doesn’t sound as difficult as cutting it out entirely. I think I could manage that.

Dr. Sherly: That’s wonderful, Mr. Ahmad! It’s really about finding what feels sustainable for you. And just to help you map things out a bit, how confident do you feel about starting with these smaller portions?

And just to help you map things out a bit ,how confident do you feel about starting with these smaller portions?

Mr. Ahmad: I’d say… maybe a 7 out of 10. It sounds manageable, but I know it might take some getting used to.

Dr. Sherly: That’s a good confidence level to start with. Let’s build on that 7 and make this a gradual shift. Small steps like these can add up over time, and you’ll find it easier to stick with them.

Mr. Ahmad: Yeah, I can see that. I’ll start with a smaller portion and see how it goes.

Dr. Sherly: Perfect! You’re setting yourself up for success, and I’ll be here to support you along the way. Just take it one step at a time, and we’ll adjust as needed.

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Explanation of Motivational Interviewing Techniques Used:

Engagement: Dr. Sherly listens empathetically and reflects Mr. Ahmad’s concerns, building rapport and creating a non-judgmental environment.

Open-Ended Questions: Dr. Sherly asks questions like “What are your thoughts on adjusting your intake, rather than eliminating it completely?” to encourage Mr. Ahmad to share his perspective.

Reflective Listening: Dr. Sherly reflects Mr. Ahmad’s ambivalence about rice by rephrasing his thoughts, validating his experience and building understanding.

Scaling Confidence: Asking Mr. Ahmad to rate his confidence level in implementing a change (“How confident do you feel…?”) helps Dr. Sherly gauge his readiness, supporting his progress at a pace that works for him.