Thirty-seven women with a mean initial weight of 98.5 +/- 18.7 kg completed a group treatment program for obese, infertile women. The program lasted for 24 weeks and included regular exercise and group discussion of topics such as coping with the psychological impact of infertility, developing healthy eating patterns, and the effects of obesity on reproductive physiology. There was significant weight loss (mean weight loss 6.2 +/- 4.5 kg, p < 0.001) and improvement on measures of self-esteem, anxiety, depression, and general health. Twenty-nine women became pregnant during the follow-up period (21-36 months). Two women were avoiding pregnancy, so only six who had completed the group program and wished to become pregnant had not conceived by the end of the follow-up period. A further five women did not complete the program as they became pregnant while attending the group. Our results suggest that active measures to improve mood and self-esteem, along with better nutrition and weight reduction through diet and exercise, can produce considerable improvement in the outcome of treatment for infertility in obese women.