The 5A’s of obesity management

Travis Saunders
If you listened to our new podcast from the “Is Obesity a disease?” debate, you will have heard a brief discussion of the “5 A’s of Obesity Management”, a new project developed by the Canadian Obesity Network. The 5 A’s are based on previous “5 A’s” initiatives focusing on smoking cessation and increasing physical activity, and are built around 5 core principles of obesity management:

Obesity is a Chronic Condition: Obesity is a chronic and often progressive condition not unlike diabetes or hypertension. Successful obesity management requires realistic and sustainable treatment strategies. Short-term “quick-fix” solutions focusing on maximizing weight loss are generally unsustainable and therefore associated with high rates of weight regain.

Obesity Management is About Improving Health and Well-being, and not Simply Reducing Numbers on the Scale: The success of obesity management should be measured in improvements in health and well-being rather than in the amount of weight lost. For many patients, even modest reductions in body weight can lead to significant improvements in health and well-being.
Early Intervention Means Addressing Root Causes and Removing Roadblocks: Successful obesity management requires identifying and addressing both the ‘root causes’ of weight gain as well as the barriers to weight management. Weight gain may result from a reduction in metabolic rate, overeating, or reduced physical activity secondary to biological, psychological or socioeconomic factors. Many of these factors also pose significant barriers to weight management.

Success is Different for Every Individual: Patients vary considerably in their readiness and capacity for weight management. ‘Success’ can be defined as better quality-of-life, greater self-esteem, higher energy levels, improved overall health, prevention of further weight gain, modest (5%) weight loss, or maintenance of the patient’s ‘best’ weight.
A Patient’s ‘Best’ weight may never be an ‘Ideal’ weight: An ‘ideal’ weight or BMI is not a realistic goal for many patients with obesity, and setting unachievable targets simply sets up patients for failure. Instead, help patients set weight targets based on the ‘best’ weight they can sustain while still enjoying their life and reaping the beneits of improved health.

The A’s themselves are as follows:
Ask for permission to discuss weight and explore readiness for change.
Assess obesity related health risk and potential “root causes” of weight gain.
Advise on obesity risks, discuss benefits treatment options.
Agree on realistic weight-loss expectations and on a SMART plan to achieve behavioral goals.
Assist in addressing drivers and barriers, offer education and resources, refer to provider, and arrange follow-up.
Courtesy http://blogs.plos.org. Travis Saunders has a PhD in Human Kinetics, and is currently an Assistant Professor in Applied Human Science.