Since changes in a patient’s lifestyle are the mainstay of obesity treatment, care needs to be taken to ensure that the patient has thoroughly considered both the pros and cons of change for them at this time. Potential difficulties to success need to be identified from the outset and steps taken to overcome them. The maintenance of a ‘food and activity’ diary will raise patients’ awareness of their own behaviour with regard to eating and exercise – the first and most important step towards changing things.