Although we’ve never met in person, we chose to author this book together because we were linked by colleagues who have been powerful mentors for each of us. The personal and professional lives of Bob Anderson, Marti Funnell, and the late Anita Carlson personify the philosophical foundation of this book. Many people have read about their philosophy of care, but experiencing firsthand the kind of relationship they advocate confirms the power of everything they have written. Our core agreement with our colleagues’ approach to patient-provider relationships made it often possible to understand each other’s intent while we worked on the language needed to describe it to others.

To our other colleagues working with the problem-solving model, collaborative care, and lifestyle change, we thank Barbara Anderson, Ingalena Andersson, Betty Brackenridge, Elisabeth Grimholm, and Birgit Hannikainen.

To our supportive and patient friends, Wally Arnold, Nan Bidlack, Per Eriksson, Joan Goodwin, Ingrid Linde, Gudrun Persson, Margareta Lundgren, Margit Lundqvist, Anna-Lena and Loffe Undén Elofsson, and Ulla Vedda, we also owe a heartfelt acknowledgment.

To Bernt Lindahl and Chris Wallin, for their interest in obesity treatment and their support for working with the problem-solving model and lifestyle change, we thank them for their insight.

We thank our colleagues with the Obesity Unit and Clinic of Metabolism and Endocrinology at the Karolinska University Hospital, Stockholm, and with the Michigan Diabetes Research and Training Center at the University of Michigan, Ann Arbor.

We are indebted to the wisdom of Robin Nwankwo, Betty Brackenridge, and Rachel Trevathon, dietitians whose professional practice remains consistent with their understanding that prefabricated solutions rarely fit anyone’s personal food habits or style.

Betty Brackenridge is owed further thanks, as is Chris Swensen. They documented that significant improvement in outcome measures are possible when patients receive the information and support they need to make informed decisions about their care.

This book would not exist were it not for the interest, questions, and feedback provided by students, health care providers, and other participants in seminars, lectures, and workshops.

Acknowledgment must be given to all those who helped us appreciate that living with a chronic disease is difficult, that there is always more to the story than is told, and that our professional challenge is to control our comments, not their behavior.

For our colleagues, family, friends, and patients who have demonstrated with their lives the effectiveness of the problem-solving model, who make it clear that they are in charge of their lives, and who demonstrated the power of personal goals in propelling change, we thank them for their inspiration.

To Stig Lundquist, whose feedback on the first version of the manuscript was invaluable, and to our reviewers, who shared their time, effort, expertise, insight, and suggestions to improve the text, we owe a gracious thanks.

To Victor Van Beuren, Christine Charlip, Greg Guthrie, Abe Ogden, and others at the American Diabetes Association, we owe our thanks for their support of the idea of this book and for guiding it through to this finished product.

Finally, we must acknowledge and dedicate this book to our patients, for whom this book is written. Without their trust, courage, and willingness to share their stories, we would not be where we are today in the realm of supporting behavior change. We must thank our patients for the privilege of watching resistance to behavior change dissolve when they realized that no one was pushing.

Birgitta Adolfsson, PhD

Marilynn S. Arnold, MS, RD, LD, CDE

February 2006