The most "obvious" approach to weight loss is to reduce your calorie intake (diet) as well as increase your energy expenditure (exercise). However, diets and exercise frequently do not work long term for those with a serious weight problem. That does not mean that you can’t have some short term success such as a few months or years. However, some studies have shown that diets and exercise frequently fail for those with a serious weight problem.

Many people with a serious weight problem have cycles of weight gain and loss as they try different diets and exercises; these cycles are called the "yo–yo effect"”.

If you’re not a surgical candidate, your only choice is to continue to try diets and exercises. If you are a surgical candidate, the best chance of long term success after surgery will require you to continue with an exercise and diet program for the rest of your life. If you are a surgical candidate and have never tried a diet or exercise, chances are your surgeon will not operate on you until you have – to show whether they do or do not work for you.