Traditional treatment of obesity: does it work?

Obesity is the most important nutritional disorder in the developed world, since up to 10% of the population are obese. The place of physical activity and diet in the aetiology of obesity is discussed. The traditional treatment of obesity includes change in lifestyle, nutritional education and modification and increase in exercise. These changes are important for long-term success. There are a number of other treatment options including anorectic drugs, the use of very low calorie diets and surgical techniques which may have some clinical role. For the extremely obese patient with established complications surgery may be the most appropriate intervention and may be life-saving. Most studies of traditional treatment have demonstrated limited success. The prevention of obesity is therefore of great importance. Large-scale studies have shown that it is possible to modify behaviour and cardiovascular risk factors. The prevention of obesity requires a coordinated approach with targeting of children and their carers. Governmental involvement and legislation is essential. The future holds the promise of more imaginative and coordinated therapies for obesity using the skills of physicians, nutritionists, exercise physiologists and psychologists. Different forms of treatment may be appropriate for different groups of obese patients.