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The 5A approach to obesity

Health and medical research bodies around the world, including the National Health and Medical Research Council in Australia, suggest clinicians use the 5A approach to manage overweight and obesity with their patients. The 5A approach is a simple acronym to group together actions or steps that a clinician and patient can collaboratively work through in approaching weight loss as a treatment goal.

Health and medical research bodies around the world, including the National Health and Medical Research Council in Australia, suggest clinicians use the 5A approach to manage overweight and obesity with their patients. The 5A approach is a simple acronym to group together actions or steps that a clinician and patient can collaboratively work through in approaching weight loss as a treatment goal.

Patient-centred care

This approach was developed to address stigma and the poor outcomes seen with simple or tokenistic advice on weight. It integrates patient-centered care, a collaborative therapeutic relationship and health behaviour change principles as outlined briefly in the figure below. It is the patient’s choice whether they want to engage in a discussion or plan about their weight – in terms of timing, whether they want to work with you or an alternative clinician, or at all. When a patient is open to engaging in a conversation and treatment plan for weight management, it is the role of the health professional to frame and shape the conversation to the individual including exploring approaches that may or may not have worked in the past.

5A's of obesity management. Ask (Permission to discuss weight. Explore readiness to change/address). Assess (Obesitiy stage and/or BMI, for co-morbidities. Drivers, complications and barriers). Advise (Discuss benefits of modest weight loss in context. Discuss treatment options). Agree (Agree on realistic weight loss expectations. Agree on SMART behaviour change goals. Agree on a treatment plan.) Assist (Assist in addressing drivers and barriers. Assist in accessing resources. Refer prn / arrange follow up.)

The 5A approach to managing obesity can be tailored and utilised by clinicians in their approach to supporting patients with weight management. It can provide a framework to help in assessing weight, specifically weight history, as well as the potential drivers and lifestyle barriers and facilitators to weight gain/loss and the possible need for referral to a medical practitioner, dietitian or psychologist. In some cases in the literature, you may see that an additional ‘A’ has been added … ‘Arrange’ as the final step

Watch
Watch the following five minute video developed by the Canadian Obesity Network, with a multi-disciplinary team of experts discussing the implementation of the 5A approach to obesity in a primary care setting.

This is an additional video, hosted on YouTube.

The 5As of Obesity Management™
Source: Canadian Obesity Network, https://obesitycanada.ca/resources/5as/

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