Obesity Evaluate Overview

Framework Steps and Interventions

The Evaluate step of the KAER framework aligns with the Agree and Assist steps of the 6 As process described in the Obesity Management in Practice section.  

Agree: Develop common goals using the SMART (specific, measurable, attainable, relevant, and time-based) framework. 

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.)

Obesity Management in Primary Care

Because obesity is a chronic, relapsing, multifactorial disease, treatment should ideally be multidisciplinary and sustainable (Busetto et al., 2024). Ideally, the obesity care team would include an obesity medicine specialist. However, many people lack access to this level of care and primary care providers play fundamental roles in supporting their patients in the management of obesity (Pennings et al., 2025). Primary care providers can evaluate available interventions, collaborate with patients to develop an individualized weight management plan, and work in collaboration with their patients on the implementation and sustainability of these plans (Pennings et al., 2025). 

Comprehensive Approaches to Sustainable Weight Loss

Weight loss requires the total expenditure of energy/calories to exceed the total intake of energy/calories. Ideally, interventions that modify dietary intake and increase physical activity are implemented together to work in tandem to address both sides of this equation.

Sustainment Over Time

However, such interventions require behavioral changes that can be very difficult to implement and sustain over time, and additional supports are often necessary.

Holistic Care

Additionally, addressing the psychological, emotional, and social components of obesity management is crucial (Rand et al., 2017).

Individualized Support

These supports may include education and counseling (including referrals to specialists such as dietitians, behavioral therapists, and psychologists), medications, surgery, and digital health programs. Supports should be individualized based on each patient’s goals for therapy and baseline status across multiple domains.

Personalized Weight Management

Older adults are a diverse population with wide variation in activity levels, health status, finances, access to transportation, access to health care, attitudes about medicine, socialization levels and needs, and personal and cultural views about weight and body size. As a result, intervention must be tailored to each individual’s needs. Weight management approaches for older adults should consider any functional deficits, physical activity limitations, dietary needs, and other individualized considerations. Furthermore, it is crucial to preserve muscle mass and ensure that adequate nutrition is maintained during weight loss in older adults to prevent malnutrition and the development of sarcopenic obesity. Finally, a comprehensive person-centered approach to treatment should consider and manage related comorbid conditions.

Evaluate | Approaches to Implement