Clinical Review: Modified 5 As: Minimal Intervention for Obesity Counseling in Primary Care

Overview

Journal Can Fam Physician

Specialties General Medicine
Public Health

Date 2013 Jan 24

PMID 23341653

Citations 95

Authors

Michael Vallis

Helena Piccinini-Vallis

Arya M Sharma

Yoni Freedhoff

Affiliations

Soon will be listed here.

Abstract

Objective: To adapt the 5 As model in order to provide primary care practitioners with a framework for obesity counseling.

Sources Of Information: A systematic literature search of MEDLINE using the search terms 5 A's (49 articles retrieved, all relevant) and 5 A's and primary care (8 articles retrieved, all redundant) was conducted. The National Institute of Health and the World Health Organization websites were also searched.

Main Message: The 5 As (ask, assess, advise, agree, and assist), developed for smoking cessation, can be adapted for obesity counseling. Ask permission to discuss weight; be nonjudgmental and explore the patient's readiness for change. Assess body mass index, waist circumference, and obesity stage; explore drivers and complications of excess weight. Advise the patient about the health risks of obesity, the benefits of modest weight loss, the need for a long-term strategy, and treatment options. Agree on realistic weight-loss expectations, targets, behavioural changes, and specific details of the treatment plan. Assist in identifying and addressing barriers; provide resources, assist in finding and consulting with appropriate providers, and arrange regular follow-up.

Conclusion: The 5 As comprise a manageable evidence-based behavioural intervention strategy that has the potential to improve the success of weight management within primary care.

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