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Can Fam Physician. 2013 Jan;59(1):27-31.

Clinical review: modified 5 As: minimal intervention for obesity counseling in primary care.

Author information

  • 1Dalhousie University, Family Medicine, Suite 4060, Lane Bldg, 5909 Veteran's Memorial Lane, Halifax, NS B3H 2E2. tvallis@dal.ca

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.

Comment in

PMID:
23341653
PMCID:
PMC3555649
[PubMed - indexed for MEDLINE]
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