Every primary care unit should be prepared to provide lifestyle education (either as a group or individual basis). Successful lifestyle education has a beneficial effect on all metabolic abnormalities . The primary aim is to introduce permanent lifestyle changes. Weight reduction is not always the goal and not the only goal; increasing the amount of physical exercise without a weight change is also beneficial as are changes in the content of the diet even if weight reduction is unsuccessful . A very low energy diet (VLED) is no better than other methods in weight reduction. Prevention of relapses after dieting is essential. Medication may be of support in this.