The purpose of the present paper is to outline the current situation in the management of obesity in adults, and to make some suggestions as to how health professionals involved in obesity treatment can best address this growing problem. Dietitians and nutritionists have long been involved in the treatment of obesity, and have a vital role to play in the battle to reverse the increasing prevalence of this major public health problem. However, the current management of obesity is far from ideal. There is evidence to suggest that in general health care, even when there are clearly effective clinical interventions, health professionals may not practise in the best way. Furthermore, some professionals may also hold negative attitudes towards the obese. These are the subject of a systematic review on improving health professionals' practice and organization of care in obesity treatment, the preliminary findings of which will be discussed in the present paper (Harvey et al. 1998a,b). A new approach to obesity is required, encompassing effective treatment and prevention strategies. A greater understanding of the problems faced by the obese individual in attempting to lose weight is also needed, with a range of treatment approaches on offer to acknowledge the heterogeneity of obesity. Those health professionals involved in obesity treatment must consider the impact of dietary advice given in a consultation against the impact of environmental cues that assail the patient as soon as they leave the room. Tackling the obesity epidemic requires action at the individual and population level if we are to see any reduction in prevalence.