One hundred six massively obese patients, who each lost at least 45 kg, were treated as outpatients with the rice/reduction diet, exercise, and motivational enhancement under daily supervision. Average weight loss was 63.9 kg. Forty-three patients achieved normal weight. Men lost weight at a greater rate than women. Concomitant with weight reduction, there were significant decrements in blood pressure; fasting and two-hour postprandial blood glucose, serum triglyceride, and serum uric acid levels, and heart-chest ratio as evidenced on chest x-ray film. Electrocardiographic and retinal venous changes improved. Serum cholesterol level did not change significantly. This study demonstrates that massively obese persons can achieve marked weight reduction, even normalization of weight, without hospitalization, surgery, or pharmacologic intervention. Accompanying cardiovascular risk factors show great decrements concomitant with weight loss.