REVIEW PRACTICE FOR CSOWM
2026/2027 ACTUAL QUESTIONS
WITH VERIFIED ANSWERS.
In the 5A counseling framework, the first step in the
management of patients affected by overweight or obesity is
a. Assess (BMI, waist circumference, drivers and complications
of excess weight)
b. Ask (for permission to discuss body weight)
c. Advise (about health risks associated with obesity and
benefits of weight loss)
d. Agree (upon realistic weight loss targets and expectations) -
correct answer-Answer: B. Ask (for permission to discuss body
weight)
Explanation: The 5As are Ask, Assess, Advise, Agree, and
Assist. Ask is the first step because some patients will not be
ready to progress into the assessment phase, and this should
be respected. Prior to discussing weight and weight
management, permission to discuss the subject should be
sought.
Freshwater M et al. Behavior, motivational interviewing, eating
disorders, and obesity management technologies: an Obesity
Medicine Association (OMA) clinical practice statement (CPS)
2022. Obes Pillars. 2022;2:100014.
,Sturgiss E, van Weel C. The 5As framework for obesity
management: do we need a more intricate model? Can Fam
Phys. 2017;63:506-8.
Your 34-year-old patient with a BMI of 35.5 kg/m2 presents to
the clinic for an annual visit. She has a history of diabetes,
dyslipidemia, and hypertension. What % weight loss is needed
to see a therapeutic benefit from all of her obesity-related
complications?
a. at least 3%, with max benefit >/= 15%
b. at least 5%, with max benefit >/= 15%
c. at least 10%
d. at least, 15% - correct answer-Answer: The correct answer is
B. Studies have demonstrated that treatment with anti-obesity
medicines can encourage 4-20% weight loss in combination
with lifestyle modifications compared to placebo. In effort to
treat to target, the required weight loss for therapeutic benefit of
obesity-related complications is as follows:
Diabetes = 3 to 10%
Dyslipidemia= 3 to >15%
Hypertension= 5 to >15%
For this patient to be see a benefit of all of her comorbidities,
the minimum amount of weight loss would be 5%.
,Reference:Cefalu WT, et al.Diabetes Care. 2015;38(8):1567-
1582
Mr. Nguyen is a 41-year-old, Asian American patient with a BMI
of 27.8 kg/m2 and a waist circumference of 90 cm. Which of the
following risk stratification class would Mr. Nguyen be
categorized in?
a. normal weight
b. pre-obesity/overweight
c. obese
d. i don't know - correct answer-Answer: The correct answer is
C. According to the 2023 American Diabetes Guideline
Recommendations, the BMI cutoff for Asians and Asian
American populations is lower than in other populations due to
differences in body composition and cardiometabolic risk. A
BMI >23 kg/m2 may indicate pre-obesity, a BMI >27.5 kg/m2
may indicate class I obesity, a BMI >32.5 kg/m2 may indicate
class II obesity, and a BMI >37.5 kg/m2 may indicate class III
obesity.
Based on Mr. Nguyen's BMI, this is in range of the Class I
obesity risk group.
Reference: Diabetes Care 2023; 46(Suppl.1):S128-S139
, Results from the SURMOUNT-1 trial investigating tirzepatide in
patients who were overweight or obese, 15 mg weekly doses of
tirzepatide demonstrated what amount of weight loss compared
to placebo?
a. 5%
b. 10%
c. 15%
d. >/= 20% - correct answer-Answer: The correct answer is D.
The pivotal, phase III, double-blind, randomized, controlled
SURMOUNT-1 trial investigated tirzepatide treatment in
individuals with obesity or overweight who did not have
diabetes. Results demonstrated that at 5 mg, 10 mg, and 15
mg of once-weekly tirzepatide resulted in weight reduction in
participants. At the highest dose, this resulted in 20.9% weight
loss compared to placebo. Semaglutide at 2.4 mg
demonstrated 14.9% weight loss compared to placebo.
Reference: Wilding, J, et al. New England Journal of Medicine
384, 989-1002; Jastreboff AM, Aronne LJ, Ahmad NN, et al. N
Engl J Med. 2022;387(3):205-216
To facilitate shared decision-making, what counseling and
education points would you provide a patient regarding second-
generation AOMs, allowing them to make an informed decision
about their therapy?
2026/2027 ACTUAL QUESTIONS
WITH VERIFIED ANSWERS.
In the 5A counseling framework, the first step in the
management of patients affected by overweight or obesity is
a. Assess (BMI, waist circumference, drivers and complications
of excess weight)
b. Ask (for permission to discuss body weight)
c. Advise (about health risks associated with obesity and
benefits of weight loss)
d. Agree (upon realistic weight loss targets and expectations) -
correct answer-Answer: B. Ask (for permission to discuss body
weight)
Explanation: The 5As are Ask, Assess, Advise, Agree, and
Assist. Ask is the first step because some patients will not be
ready to progress into the assessment phase, and this should
be respected. Prior to discussing weight and weight
management, permission to discuss the subject should be
sought.
Freshwater M et al. Behavior, motivational interviewing, eating
disorders, and obesity management technologies: an Obesity
Medicine Association (OMA) clinical practice statement (CPS)
2022. Obes Pillars. 2022;2:100014.
,Sturgiss E, van Weel C. The 5As framework for obesity
management: do we need a more intricate model? Can Fam
Phys. 2017;63:506-8.
Your 34-year-old patient with a BMI of 35.5 kg/m2 presents to
the clinic for an annual visit. She has a history of diabetes,
dyslipidemia, and hypertension. What % weight loss is needed
to see a therapeutic benefit from all of her obesity-related
complications?
a. at least 3%, with max benefit >/= 15%
b. at least 5%, with max benefit >/= 15%
c. at least 10%
d. at least, 15% - correct answer-Answer: The correct answer is
B. Studies have demonstrated that treatment with anti-obesity
medicines can encourage 4-20% weight loss in combination
with lifestyle modifications compared to placebo. In effort to
treat to target, the required weight loss for therapeutic benefit of
obesity-related complications is as follows:
Diabetes = 3 to 10%
Dyslipidemia= 3 to >15%
Hypertension= 5 to >15%
For this patient to be see a benefit of all of her comorbidities,
the minimum amount of weight loss would be 5%.
,Reference:Cefalu WT, et al.Diabetes Care. 2015;38(8):1567-
1582
Mr. Nguyen is a 41-year-old, Asian American patient with a BMI
of 27.8 kg/m2 and a waist circumference of 90 cm. Which of the
following risk stratification class would Mr. Nguyen be
categorized in?
a. normal weight
b. pre-obesity/overweight
c. obese
d. i don't know - correct answer-Answer: The correct answer is
C. According to the 2023 American Diabetes Guideline
Recommendations, the BMI cutoff for Asians and Asian
American populations is lower than in other populations due to
differences in body composition and cardiometabolic risk. A
BMI >23 kg/m2 may indicate pre-obesity, a BMI >27.5 kg/m2
may indicate class I obesity, a BMI >32.5 kg/m2 may indicate
class II obesity, and a BMI >37.5 kg/m2 may indicate class III
obesity.
Based on Mr. Nguyen's BMI, this is in range of the Class I
obesity risk group.
Reference: Diabetes Care 2023; 46(Suppl.1):S128-S139
, Results from the SURMOUNT-1 trial investigating tirzepatide in
patients who were overweight or obese, 15 mg weekly doses of
tirzepatide demonstrated what amount of weight loss compared
to placebo?
a. 5%
b. 10%
c. 15%
d. >/= 20% - correct answer-Answer: The correct answer is D.
The pivotal, phase III, double-blind, randomized, controlled
SURMOUNT-1 trial investigated tirzepatide treatment in
individuals with obesity or overweight who did not have
diabetes. Results demonstrated that at 5 mg, 10 mg, and 15
mg of once-weekly tirzepatide resulted in weight reduction in
participants. At the highest dose, this resulted in 20.9% weight
loss compared to placebo. Semaglutide at 2.4 mg
demonstrated 14.9% weight loss compared to placebo.
Reference: Wilding, J, et al. New England Journal of Medicine
384, 989-1002; Jastreboff AM, Aronne LJ, Ahmad NN, et al. N
Engl J Med. 2022;387(3):205-216
To facilitate shared decision-making, what counseling and
education points would you provide a patient regarding second-
generation AOMs, allowing them to make an informed decision
about their therapy?
