Fitzpatrick Stephanie L, Wischenka Danielle, Appelhans Bradley M, Pbert Lori, Wang Monica, Wilson Dawn K, Pagoto Sherry L
Department of Preventive Medicine, Rush University Medical Center, Chicago, Ill.
Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY.
Am J Med. 2016 Jan;129(1):115.e1-7. doi: 10.1016/j.amjmed.2015.07.015. Epub 2015 Jul 31.
On behalf of the Society of Behavioral Medicine, we present a model of obesity management in primary care based on the 5As counseling framework (Assess, Advise, Agree, Assist, and Arrange). Primary care physicians can use the 5As framework to build and coordinate a multidisciplinary team that: 1) addresses patients' psychosocial issues and medical and psychiatric comorbidities associated with obesity treatment failure; 2) delivers intensive counseling that consists of goal setting, self-monitoring, and problem solving; and 3) connects patients with community resources to assist them in making healthy lifestyle changes. This paper outlines reimbursement guidelines and weight-management counseling strategies, and provides a framework for building a multidisciplinary team to maximize the patient's success at weight management.
我们谨代表行为医学协会，提出一个基于5A咨询框架（评估、建议、商定、协助和安排）的初级保健中肥胖管理模型。初级保健医生可以使用5A框架来组建和协调一个多学科团队，该团队能够：1）解决患者与肥胖治疗失败相关的心理社会问题以及医学和精神科合并症；2）提供包括目标设定、自我监测和问题解决在内的强化咨询；3）将患者与社区资源联系起来，帮助他们做出健康的生活方式改变。本文概述了报销指南和体重管理咨询策略，并提供了一个构建多学科团队的框架，以最大限度地提高患者在体重管理方面的成功率。
