It’s the holiday season, but it is not too early to begin counseling patients on weight loss for the New Year. 

By: Linda Anegawa, M.D., F.A.C.P. 

With 70 percent of Americans overweight or obese, we are in the throes of a serious obesity epidemic.  Overweight and obesity can be a pre-cursor for many serious health conditions, including diabetes, hypertension, cardiovascular disease, stroke, many cancers, degenerative joint disease and non-alcoholic fatty liver disease.  And during the holidays the average American not only gains 7 pounds, they unfortunately do not lose the weight after the season, leading to continued, worsening obesity and more complications of fat-mass disease.

Recognizing the severity of this public health crisis, our government has taken heed. The Affordable Care Act includes provisions that promote preventive care, including obesity-related services and coverage. One provision expands the requirements for new health plans to cover the recommendations of the U.S. Preventive Services Task Force (USPSTF), including counseling for obesity. Physicians can lean on the 5A’s approach adopted by the USPSTF in counseling their patients about weight loss.

Here are the 5 A’s:

  1. Assess health risk(s), as well as factors affecting an individual’s behaviors, as well as their goals and what methods might be best for any given individual.  Express specific concerns to your patients about the impact their weight may have on their health.
  2. Give specific, clear, and personalized advice, including information about personal health harms and benefits. Emphasize that even a modest amount of weight loss can postively impact health and longevity.
  3. Collaboratively select appropriate treatment goals and methods based on the patient’s interest in and willingness to change their behaviors.
  4. Using behavior change techniques (self-help and/or counseling), aid the patient in achieving agreed-upon goals by acquiring the skills, confidence, and social/environmental supports for behavior change, supplemented with medical treatments when appropriate.
  5. Schedule follow-up contacts (in person ideally, or alternatively by phone) to provide ongoing assistance and support and adjust the treatment plan as needed, including referral to more intensive or specialized treatment.

Lifestyle adjustments are needed to lose weight; this much we know and understand. The challenge is for patients to find the time, the tools and resources to cultivate this success. The support and constant encouragement of clinicians is critical.  Your patients may not yet be in “New Year’s Resolution Mode,” however planting the seeds now increases the likelihood of the message being heard and implemented on January 1 and throughout 2017.

To join the ranks of healthcare providers fighting obesity, tweet us at @DrsFightObesity  or use #DoctorsFightingObesity to keep the conversation going.


Linda Anegawa, M.D., F.A.C.P. is the founder of OSR Weight Management-Hawaii Metabolic Medicine. She serves on the University of Hawaii’s medical school faculty and developed the school’s first Obesity Medicine interdisciplinary clerkship experience. Dr. Anegawa also sits on the Ideal Protein Medical Advisory Board.