American Society of Bariatric Physicians Includes EOSS and 5As in Its Obesity GuidelinesThursday, November 21, 2013
Last month, the American Society of Bariatric Physicians released its latest Obesity Algorithm, a rather comprehensive compilation of recommended approaches to the assessment, diagnosis and management of obesity in clinical practice.
Regular readers will appreciate my delight to see that two concepts, that both found their first mention and initial conceptualization on these very pages, have now found their way into these recommendations.
The first is the Edmonton Obesity Staging System (EOSS), which rates the severity of obesity based on the presence of medical, mental and functional problems related to excess weight rather than simply numbers on the scale. It is now well established that EOSS is a far better predictor of obesity related mortality risk than BMI, waist circumference (WC) or “metabolic syndrome”.
The new ASPB alogrithm now recommends that EOSS assessment (along with BMI, WC and % body fat) be included in the initial assessment of all patients presenting with excess weight.
The second concept adopted by ASBP is the 5As of Obesity Management (Ask, Assess, Advise, Agree, Assist) developed by a national panel of Canadian obesity experts and primary care providers with substantial input from patients, recently launched by the Canadian Obesity Network and now shown to facilitate provider-patient discussions and treatment of obesity.
Both concepts are “made in Canada” and I am certainly proud to have been part of developing both of these approaches to obesity assessment and management, which I see as major advances in “taking obesity seriously”.
It is my sincere hope that with the incorporation of both EOSS and the 5As of Obesity Management into the ASBP guidelines, that these concepts will find global acceptance and make their way into recommendations and guidelines of other organisations around the world.
In the meantime, we and others will continue our work on further validating these concepts and demonstrating their utility in clinical practice.
If you have already incorporated EOSS and the 5As in your practice, I’d certainly like to hear about it.
Click here to download your personal EOSS chart and pocket card
Click here to download a PPT or PDF of the 5As of Obesity Management
Click here to watch a short video on the 5As of Obesity Management
Click here to order your personal 5As of Obesity Management tool kit
Friday, November 22, 2013
Great post Dr. Sharma. I am a nurse practitioner and ASBP member. I have specialized in obesity medicine for 8 1/2 years and have my own practice in Seattle, WA.
I have been using the EOSS in my evaluation of all new and existing patients since I first learned about it from you two years ago at an ASBP conference. Thank you so much for developing it!
I note the class and stage of obesity in all my patients’ progress reports. In addition to being in the chart, these reports are also sent to their PCPs and other pertinent specialists (ortho, psych, GI, etc.) I’ve included EOSS in professional articles and presentations I’ve given to other medical professionals with the goal of getting it out there.
I also keep a copy of the EOSS chart handy during patient visits. When I am evaluating new patients I show them the chart and where they fall. They appreciate a more specific evaluation and the way that it personalizes their treatment plan.
As an ASBP member, I was thrilled with the unveiling of the Algorithm at our conference in Phoenix. I was equally thrilled that the EOSS and 5 As were included. I look forward to using the Algorithm in the coming months and years. Thanks for your contributions to it!