title: A review of the use of the 5 A's model for weight loss counselling: differences between physician practice and patient demand.
abstract: BACKGROUND
  The 5 A's (Assess, Advise, Agree, Assist and Arrange) is a model that can be used by primary care physicians and practitioners to promote patient behaviour change. The 5 A's model is a viable intervention for encouraging weight management in response to the epidemic of obesity among patients.
  
  
  OBJECTIVE
  To identify and summarize quantitative research related to the 5 A's patients want to receive from their physicians during weight loss discussions and how frequently physicians use each practice.
  
  
  METHODS
  We conducted a systematic literature review of the MEDLINE/PubMed database using relevant keywords. Of 230 articles originally identified, 15 articles included quantitative research data from cross-sectional studies related to the aim of this review.
  
  
  RESULTS
  Based on the available evidence, the majority of patients want to discuss weight loss with their physicians, with the Assist and Arrange aspects of the 5 A's being most desired. However, physicians most frequently Advise and Assess, and rarely Agree, Assist or Arrange.
  
  
  CONCLUSIONS
  There are some significant limitations to the available evidence, including a limited number of studies addressing patient preference, inconsistent assessment of all aspects of the 5 A's, a lack of longitudinal designs and failure to take contextual factors such as patient and physician characteristics into account when interpreting study results. Future studies should address these limitations, document the outcomes that result from better physician training in lifestyle modification strategies and determine how to best routinely implement all aspects of the 5 A's for weight management in family practice settings.
authors.affiliation: Department of Family and Community Medicine and.
authors.forename: Elaine A
authors.initials: EA
authors.lastname: Sherson
authors.affiliation: Department of Family and Community Medicine and Department of Individual, Family, and Community Education, University of New Mexico, Albuquerque, NM 87131, USA. eyjimenez@unm.edu.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Yakes Jimenez
authors.affiliation: Department of Family and Community Medicine and.
authors.forename: Nikki
authors.initials: N
authors.lastname: Katalanos
mesh_terms: D000328:Adult; D003376:Counseling / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000628:therapy*; D050177:Overweight / Q000628:therapy; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care; D015431:Weight Loss; D055815:Young Adult
keywords: Counselling; obesity; overweight; patients; physicians; primary care; weight Loss.