The 6 As Approach to Weight Management

The 5 A's intervention that has been popularized for tobacco cessation has been adapted as a six-pronged (the 6 As) approach for discussing weight that aligns with the KAER framework (Gallagher et al., 2021):

Ask:

Request permission to discuss the patient’s weight; avoid paternalism by using people-first language (e.g., say "people with obesity"; emphasize obesity is a disease that results from an imbalance in body systems, not a personal failure or flaw) (OAC, 2025). (Aligns with Kickstart.)

Assess:

Prescreen data, laboratory results, and weight-related comorbidities (and when needed, other tools). (Aligns with Assess.)

Advise:

Use a clear, strong, and personalized manner to present the benefits of health improvement through obesity care and weight management. (Aligns with Evaluate.)

Agree:

Develop common goals using the SMART (specific, measurable, attainable, relevant, and time-based) framework. (Aligns with Evaluate.)

Assist:

Open the door to the full range of interventions, including counseling, physical activity, behavioral and nutritional interventions, medications, and surgical options, and make referrals to community resources. (Aligns with Evaluate and Refer.)

Arrange:

Schedule a follow-up face-to-face or telehealth visit to continue conversations and assess progress. (Aligns with Refer.)

“The KAER framework really has been an unbelievable addition... It’s critical to use person-first language and create a clinical environment that is sensitive and empathetic to patients’ experiences with obesity.” John Batsis, MD, FACP, AGSF, FTOS, FGSA, University of North Carolina at Chapel Hill

Primary care providers can utilize this approach as an overall framework for collaborating with people with overweight and obesity, using principles related to assessing readiness to change and motivational interviewing to help move people through the process.


Obesity Management in Practice

Recognize Obesity as a Disease in Need of Treatment | Assess for the Presence of Bias and Work to Address It | Seek Resources and Continuing Education  | The 6 As Approach to Weight Management | Become Familiar with Principles of Readiness to Change  | Consider Motivational Interviewing Strategies | Identify Opportunities for Reimbursement | Practice Management References