New treatment strategies have failed to control the global increase in obesity. Here two scientists discuss common barriers that need to be overcome by both healthcare professionals and patients if weight reduction is to be achieved and maintained

The 1980s and ‘90s witnessed alarming increases in obesity across the globe.1 This epidemic has not been slowed by new treatment strategies, leading some health professionals to doubt if they can help their patients. A recent audit documented wide variation in the management of overweight and obese patients in general practices in England and uncertainty about which treatments were most effective.2 Healthcare providers may fail to address obesity for many reasons, including cynicism about the efficacy of treatments, lack of time, perceived non-compliance of patients, and lack of training in counselling and motivating patients to change their behaviour. 3 4 Although the control of obesity ultimately requires population based strategies, doctors can and should provide effective individual care. We review evidence based recommendations for managing overweight and obese adults.