Modified 5 As: Minimal intervention for obesity counseling in primary care [5 A, version modifiée: Intervention minimale pour le counseling sur l'obésité en soins primaires]

摘要

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.