Obesity is a major health problem by: a high incidence (especially in industrialized countries); an impairment of life duration and quality; promote a large panel of cardiovascular, respiratory, rheumatologic, endocrine-metabolic disturbances (mortality of 1.5 to 4 times higher than in normal weight); increased surgical risk; huge psycho-social consequences. Integrative therapeutically attitude should act both on individual and population level, in order to avoid social isolation and better results. An intention to treat study was made, 12 month period of follow up, initial randomization of 6 month, 107 patients, from 287 selected. Synoptically we found: 10% good results with only lifestyle modifications and 87% good results with both lifestyle modification and medication, only 3% of failure. We obtained good results for all the anthropometrically parameter, after 1 year of treatment. The cornerstone was: high motivation and integrated treatment focused on both directions. Medication of the best choice is that which has dual effects: energy balance and eating disorders. We have to achieve a multifactor approach of treating obese persons as integrated treatment with a strong social component.
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