Primary care and primary healthcare in obesity management

ABSTRACT

Primary care clinicians should initiate patient-centred conversations with their patients about overweight or obesity. The 5As of Obesity ManagementTM (Ask-Assess-Advise-Agree-Assist) approach, starting with asking permission to discuss weight, is an appropriate format to use. Primary care clinicians should promote a holistic approach to weight and health focusing on health behaviours and addressing root causes of weight gain, with care to avoid stigmatizing and using overly simplistic narratives like "eat less and move more." Prescribing clinicians must be aware of obesogenic medications and consider alternatives for people living with overweight and obesity. When obesogenic medications must be used, physicians should discuss the risks with patients and institute monitoring for weight gain. Providers and patients need to be aware of the risks of weight cycling and adopt strategies that focus on sustained changes to maintain healthy habits over time.