Treatment for obesity often entails frustration for both physician and
patient because of the great difficulty of maintaining weight loss ov
er the long term. This article follows the history and treatment of a
40-year-old woman who was surprised when she was diagnosed as obese. T
he authors describe the terminology, etiology, and physiology of obesi
ty and recommend a combination of diet, nutrition education, exercise,
behavior modification, and social support. Though few physicians can
offer this comprehensive approach in their office, they can guide pati
ents in choosing an individualized combination of office-based service
s and community resources.