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Multidisciplinary approach to adult obesity therapy.

A comprehensive program has been designed to treat medically significant obesity (body mass index greater than 30). The essential components include nutritional education, exercise, mental conditioning, relaxation and assertiveness training. Adherence to this combined program is supported by rapid weight loss utilizing a protein-sparing modified fast. Initial efforts include greater than 18 kg (40 lb) weight loss in three out of four patients and greater than two years maintenance in one out of three patients. The varying success depends on patient adherence to a prolonged education program at least six months to one year directed at modification of lifestyle. Both for lasting safety and effectiveness a professional partnership is required between the physician and patient. Finally the result of therapy appears to be rehabilitation and not cure from the problem of obesity.