Core Principles of Obesity Management

Today sees the launch of the Canadian Obesity Network’s 5As of Obesity Management™, a step-by-step framework for the management of obesity in primary care.

The framework is based on five core principles (different from the 5As) that emerged from extensive consultation with patients, primary care providers and obesity experts – a process that involved numerous interviews, focus groups and surveys, spanning the past two years. In addition, the principles and messages were crafted and tested with primary care providers at conferences and workshops across Canada.

The following is a summary of the core principles, that emerged from these efforts and together provide a significant departure from traditional (‘all excess weight is bad’ and ‘eat-less-move-more’) approaches to weight management:

Obesity is a Chronic Condition: Obesity is a chronic and often progressive condition not unlike diabetes or hypertension. Successful obesity management requires realistic and sustainable treatment strategies. Short-term “quick-fix” solutions focusing on maximizing weight loss are generally unsustainable and therefore associated with high rates of weight regain.

Obesity Management is About Improving Health and Well-being, and not Simply Reducing Numbers on the Scale: The success of obesity management should be measured in improvements in health and well-being rather than in the amount of weight lost. For many patients, even modest reductions in body weight can lead to significant improvements in health and well-being.

Early Intervention Means Addressing Root Causes and Removing Roadblocks: Successful obesity management requires identifying and addressing both the ‘root causes’ of weight gain as well as the barriers to weight management. Weight gain may result from a reduction in metabolic rate, overeating, or reduced physical activity secondary to biological, psychological or socioeconomic factors. Many of these factors also pose significant barriers to weight management.

Success is Different for Every Individual: Patients vary considerably in their readiness and capacity for weight management. ‘Success’ can be defined as better quality-of-life, greater self-esteem, higher energy levels, improved overall health, prevention of further weight gain, modest (5%) weight loss, or maintenance of the patient’s ‘best’ weight.

A Patient’s ‘Best’ Weight May Never be an ‘Ideal’ Weight: An ‘ideal’ weight or BMI is not a realistic goal for many patients with obesity, and setting unachievable targets simply sets up patients for failure. Instead, help patients set weight targets based on the ‘best’ weight they can sustain while still enjoying their life and reaping the beneits of improved health.

Based on these core principles, the 5As of Obesity Management™, take the provider through a sequence of Ask, Assess, Advise, Agree, and Assist, to ensure sensitive, realistic, measurable and sustainable obesity management strategies that focus on improving health and well-being rather than simply moving numbers on a scale.

The 5As of Obesity Management™ tool kit can be downloaded or ordered by clicking here.

All proceeds from the sales of these materials go to support the Canadian Obesity Network.

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