A multiple approach programme used in 20 000 patients (3300 have been hospitalized at some time or other) for 19 years is described. It is based on operative definitions handled by an interdisciplinary team working within a therapeutic community. A diagnostic-prognostic profile is used, and so is the ambulatory treatment including an individual/group approach, and/or hospitalization with total fasting or VLCD. The general programme includes group therapy, video-tapes, physical training, occupational therapy and family guidance. This is completed with a mail and phone follow-up while the institution keeps in touch with the obese not only through its activities but also through groups carried out in the suburbs (peripheral groups).