| A | DEFINITION | RATIONALE |
|---|---|---|
| Ask | Ask permission to discuss weight; be nonjudgmental; explore readiness for change | Weight is a sensitive issue; avoid verbal cues that imply judgment; indication of readiness might predict outcomes |
| Assess | Assess BMI, WC, obesity stage; explore drivers and complications of excess weight | BMI alone should never serve as an indicator for obesity interventions; obesity is a complex and heterogeneous disorder with multiple causes— drivers and complications of obesity will vary among individuals |
| Advise | Advise on health risks of obesity, benefits of modest weight loss, the need for a long-term strategy, and treatment options | Health risks of excess weight can vary; avoidance of weight gain or modest weight loss can have health benefits; considerations of treatment options should account for risks |
| Agree | Agree on realistic weight-loss expectations and targets, behavioural changes using the SMART framework,34 and specific details of the treatment options | Most patients and many physicians have unrealistic expectations; interventions should focus on changing behaviour; providers should seek patients' “buy-in” to proposed treatment |
| Assist | Assist in identifying and addressing barriers; provide resources and assist in identifying and consulting with appropriate providers; arrange regular follow-up | Most patients have substantial barriers to weight management; patients are confused and cannot distinguish credible and noncredible sources of information; follow-up is an essential principle of chronic disease management |
BMI—body mass index; SMART—specific, measurable, achievable, rewarding, timely; WC—waist circumference