It has been suggested that about 20% of subjects undergoing weight-loss programmes can achieve a certain degree of long-term success. At present, surgery remains the only method resulting in long-term sustained weight loss, but access remains restricted. Hence it is important to analyse, in addition to pharmacotherapy, the methods to improve the effects of diet, exercise and behavioural modification. Since these techniques are less spectacular than others, there is a risk that their potential will be overlooked, in spite of the fact that they remain the main alternative for most subjects undergoing weight-loss therapy. This review summarizes realistic treatment alternatives and also provides data from a day care treatment, a strategy not much reported in the literature. This is a standard treatment modality for diabetes but less common in obesity treatment.