I Diet Modification and Calorie control1)  Conventional reducing diet :  In the overweight or moderately obese patient a practical approach is to effect an energy deficiency of 500 Kcal. Day, leading in most patients to a weight loss of 0.5 kg a week. (800-1200 K cal/day) depending  on activity, and the patient’s life style. Should contain less calories than the patient’s maintenance requirement, should contain all essential nutrients, and should contain high fibre to give stiation and should be acceptable to the patient. 2) Total starvation:  Is too drastic, disturbs body comkposition, and may lead to sudden death. Not to be attempted by patient. 3)  Very low calorie diet:  Indicated in the morbidly obese patient with risk to life and under close medical supervision only. VLCD ‘Protein sparing modified fasts’ with 50-80 gms/day high protein diet to prevent negative Nitrogen balance, and 400 K cal/day. Could be tried for short periods of up to 6 weeks, under medical supervision. Combining VLCD with behavioural therapy appears quite effective. VLCD is contraindicated in gout, renal insufficiency, and cardiac arrhythmias. Deaths reported at times in patients on long term therapy. Once the patient reverts to earlier diet, weight gain occurs.  II Physical Exercise Calls for adequate motivation, and an exercise regimen suited to individual patient with respect to age, fitness, etc. Usually, effect on body weight is only marginal.   II Behaviour modificationOf great importance in therapy and is based on study of the patietn’s attitude to food and eating, social factors that influence his eating, non-nutritive stimuli for eating etc. Advice given would include eating slowly, making eating a pure experience, eating on a small plate, eating 3 times a day at the same time and place, learning to cope with self-defeating thoughts about futility of dieting, learning about nutritional requirements and energy consumption, taking more exercise, and so on. IV Surgical management of ObesitySurgery is the last resort in refractory serious morbidity with life threatening complications and includes 1) Liposuction –Trivial amounts removed mostly for cosmetic benefits but with risks of surgery, pulmonary embolism, passage of free fat in the urine, 2) Jaw-writing and waist cord with milk diet (1800 ml giving 1200 calories), with iron and vitamin supplements. Works well with loss of 1 kg/wwek. 3) Gastroplasty by a double-line of staples producing a small gastric reservoir. Yields good results. 4) Insertion of a silicone bubble into the stomach to act as a bezoar.