Obesity

The 5 A’s of obesity management


Obesity is a chronic health problem that health professionals need to get comfortable talking about said international obesity expert Dr Arya Sharma in a session which offered delegates some practical take home tips to use with overweight and obese patients.

Obesity is a chronic health problem

At the ‘Meet the Professor’ session Dr Sharma said health professionals were just not trained to think about obesity in the same way they think about other health problems.

“If someone with diabetes came into your clinic with an HbA1c of 12%, you wouldn’t say ‘you need to get this down to 9% or I can’t help you’,” he told the packed room.

“Yet this is what we do with people who are overweight,” said Dr Sharma who is a Professor and Chair in Obesity Research and Management at the University of Alberta in the US.

We need to get comfortable talking about it

According to Dr Sharma part of the issue is that we are just not comfortable talking about weight and the need to lose weight. Health professionals also don’t have a good working knowledge of weight and appetite regulation as they do for other complex health conditions.

Yet he doesn’t believe obesity management can be a specialist area as it is too big a problem.

“General practitioners need to be as comfortable managing obesity as they are diabetes and hypertension” he told the room.

A better way of managing obesity

In collaboration with colleagues Dr Sharma developed the Canadian Obesity Network’s 5As of Obesity Management program for busy non-specialists who manage obesity in their patients.

The program involves a step-by-step framework to ensure sensitive, realistic, measurable and sustainable obesity management strategies that focus on improving health and well-being, rather than simply aiming for numbers on a scale, he explained.

Dr Sharma discussed the 5 A’s and how they apply in practice, with lots of really practical take-home tips and tactics to use with overweight and obese patients.

He explained that the 5 A’s are:

ASK for permission to discuss weight

ASSESS obesity related risk and potential ‘root causes’ of weight gain

ADVISE on obesity risks, discuss benefits and treatment options

AGREE on realistic weight loss expectations

ASSIST patient in identifying and addressing drivers and barriers

More than just BMI

One of the key messages relating to assessment was that classifying obesity based on BMI is only a measure of size and not health. He recommended also using the Edmonton Obesity Staging System (EOSS), which classifies obesity in 4 stages depending on the impact on a person’s health.

Using this in conjunction with BMI, as well as waist circumference to provide additional information on cardiometabolic risk, “helps identify patients who have or are at high-risk of obesity-related complications and are most likely to benefit from treatment”, he told delegates.

Want to know more?

Dr Sharma encouraged those who are interested to follow his blog, Dr Sharma’s Obesity Notes,where he writes about all things obesity-related, including the 5 A’s program and the EOSS. However he is currently taking a ‘blogcation’ during his trip downunder, he told delegates.

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