title: Clinical review: modified 5 As: minimal intervention for obesity counseling in primary care.
abstract: OBJECTIVE
  To adapt the 5 As model in order to provide primary care practitioners with a framework for obesity counseling.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors: Dalhousie University, Family Medicine, Suite 4060, Lane Bldg, 5909 Veteran's Memorial Lane, Halifax, NS B3H 2E2. tvallis@dal.ca
authors: Michael
authors: M
authors: Vallis
authors: Helena
authors: H
authors: Piccinini-Vallis
authors: Arya M
authors: AM
authors: Sharma
authors: Yoni
authors: Y
authors: Freedhoff
mesh_terms: D003376:Counseling / Q000379:methods*; D006801:Humans; D009765:Obesity / Q000628:therapy*; D011320:Primary Health Care / Q000379:methods*