Physicians' use of the 5As in counseling obese patients: is the quality of counseling associated with patients' motivation and intention to lose weight?
Open accessAbstract
BACKGROUND: Physicians are encouraged to counsel obese patients to lose weight, but studies measuring the quality of physicians' counseling are rare. We sought to describe the quality of physicians' obesity counseling and to determine associations between the quality of counseling and obese patients' motivation and intentions to lose weight, key predictors of behavior change. METHODS: We conducted post-visit surveys with obese patients to assess physician's use of 5As counseling techniques and the overall patient-centeredness of the physician.. Patients also reported on their motivation to lose weight and their intentions to eat healthier and exercise. One-way ANOVAs were used to describe mean differences in number of counseling practices across levels of self-rated intention and motivation. Logistic regression analyses were conducted to assess associations between number of 5As counseling practices used and patient intention and motivation. RESULTS: 137 patients of 23 physicians were included in the analysis. While 85% of the patients were counseled about obesity, physicians used only a mean of 5.3 (SD = 4.6) of 18 possible 5As counseling practices. Patients with higher levels of motivation and intentions reported receiving more 5As counseling techniques than those with lower levels. Each additional counseling practice was associated with higher odds of being motivated to lose weight (OR 1.31, CI 1.11-1.55), intending to eat better (OR 1.23, CI 1.06-1.44), and intending to exercise regularly (OR 1.14, CI 1.00-1.31). Patient centeredness of the physician was also positively associated with intentions to eat better (OR 2.96, CI 1.03-8.47) and exercise (OR 26.07, CI 3.70-83.93). CONCLUSIONS: Quality of physician counseling (as measured using the 5As counseling framework and patient-centeredness scales) was associated with motivation to lose weight and intentions to change behavior. Future studies should determine whether higher quality obesity counseling leads to improved behavioral and weight outcomes.
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Each additional counseling step is associated with increased patient motivation to lose weight (OR 1.31; 95% CI 1.11-1.55).
“each additional counseling step is associated with increased patient motivation to lose weight (odds ratio, 1.31; 95% CI, 1.11-1.55).35”
From Obesity Management in Adults (2023) · cites this paper as [35]
For both obesity and smoking, a majority of providers now perform the first 2 A's: Assess the risk behavior and advise behavior change.
“However, progress has been made, and for both obesity and smoking, a majority of providers now perform the first 2 A’s: Assess the risk behavior and advise behavior change.46–48”
From Better Population Health Through Behavior Change in Adults: A Call to Action (2013) · cites this paper as [46]
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- Authors
- Jay, M., Gillespie, C., Schlair, S., Sherman, S., & Kalet, A.
- Affiliations
- New York University (US)
- Montefiore Medical Center (US)
- VA NY Harbor Healthcare System (US)
- Corresponding author
- Jay, Melanie
- Venue
- BMC Health Services Research
- Published
- 2010-06-09
- Volume
- 10
- Issue
- 1
- Pages
- 159-159
- ISSN
- 1472-6963 (ISSN-L)
- PMC
- PMC2903583
- OpenAlex
- W2007650959
- Cited by
- 158
- References
- 48
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 9 · 2023: 4 · 2022: 7 · 2021: 9 · 2020: 8 · 2019: 10 · 2018: 11 · 2017: 11 · 2016: 13 · 2015: 19 · 2014: 15 · 2013: 15 · 2012: 11
- FWCI
- 23.56
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Health Services Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Centers for Disease Control and Prevention (CD000146-03)
- Health Resources and Services Administration
- Topics
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- obesity counseling, patient-centeredness, weight loss motivation, weight loss intentions, healthy eating intentions, exercise intention, behavior change, physician-patient communication
- MeSH terms
- Adult, Counseling, Female, Humans, Interviews as Topic, Male, Middle Aged, Models, Theoretical, Motivation, New York City, Obesity, Patients, Physician-Patient Relations, Weight Loss, Health Care Surveys, Intention, Risk Reduction Behavior
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