Obesity Management: 5A's/Key principles

Question 1

Name the 5 key principles for obesity management

Answer 1

1. obesity is a chronic condition
2. Obesity management is about improving health & well being
3. Early intervention mean addressing root causes
4. success is different for every individual
5. A patients ‘best’ weight may never be their ‘ideal’ weight

Question 2

Key principle: Obesity is a chronic condition

Answer 2

-It is chronic and progressive
-successful obesity treatment requires realistic and sustainable strategies
-short term quick fixes focus on maximizing weight loss are generally unstable and are associated with high rates of weight regain

Question 3

Key principle: Obesity management is about improving health & well being

Answer 3

-The success of obesity management should be measured in improvements in health & well being rather than amount of weight lost
-Even modest reduction in weight loss can lead to improvements in health/well being

Question 4

Key principle: Early intervention means addressing root causes

Answer 4

• Identify & address the root cause of the weight (mental health, medications, coping mechanism, etc..)
• Many factors also pose significant barriers to weight management

Question 5

Key principle: Success is different for everyone

Answer 5

-Patients may vary in their readiness and capacity for weight management
-Success looks and means something different for everyone (higher energy levels, 5% weight loss, higher self esteem, better quality of life, etc…)

Question 6

Key principle: A patients ‘best’ weight may not be their ‘ideal’ weight

Answer 6

-Their ideal weight may be unrealistic with obesity and setting unachievable goals sets them up for failure
-Help them set a best weight: Weight they can sustain while still enjoying their life and reaping the benifits of improved health

Question 7

How to use ‘ASK’ for weight change/management? (4)

Answer 7

-Be non judgemental
-Use motivational interviewing to move patients along the stages of change
-Explore readiness for change
-Create a weight friendly practice/environment (bathroom space/toilet, chairs with no arms, larger BP cuffs, larger gowns, scales that can handle higher weight)

Question 8

Wrong approaches to weight talk (3)

Answer 8

1. Scare tactics “If you don’t lose weight soon you’ll…”
2. Patronizing slogans/phrases “You just need to eat less & exercise more”
3. Guilt “Don’t you care about yourself/your health?”

Question 9

How to approach weight change talk (8)

Answer 9

1. Language (using the word weight>fat)
2. Motivation- Does the motivation come from themselves or someone else (intrinsic vs extrinsic)
3. Social support- what kind of social support do they have? Will it continue in the home?
4. Is now the best time?- Is now a good time to establish new patterns/habits? (Travelling or going through divorce?)
5. Setting the stage- Clarify expectations, work to increase likelihood of success, acknowledge their autonomy, increase engagement in management plan
6. Ask about weight change- Past failures/successes
7. Be prepared for questions- “how much should I weigh?”, “someone lost 60lbs in 4 months why can’t I?”, “What is a healthy weight?”
8. Goals- Asthetics vs health- Health related goals may be more likely to achieve than weight related goals.

Question 10

How will a patient lose weight (2)

Answer 10

1. plan or no plan- listen to their intentions & the more specific the plan the greater likelihood of success
2. Past success & failures- dont repeat what they didn’t like from the past, explore why they abaonded previous efforts. If weight was lost through suffering it will be regained.

Question 11

Diets vs healthy lifestyle

Answer 11

-Diets fail because they are performing something outside of their regular lifestyle that is not sustainable.
-Paitents should be consuming the smallest number of calories that still allows them to enjoy each day.
-Sustainibility is more important than speed of weight loss.

Question 12

why are diets ‘nightmere on ELMM street’

Answer 12

ELMM= Eat Less Move More

Question 13

Why is having a support system for weight management important? (5)

Answer 13

-efforts need to be supported at home
-partners/household should be committed
-is the family ready to change?
-Consider amount of social gatherings (social= food)
-thinking about social support indicates they have thought about change.
more planning= more success

Question 14

Why don’t the 5 A’s always work with physians

Answer 14

doctors ask & advise but rarely assess, assist & arrange