Very restrictive weight-loss diets are still recommended by a number of physicians although their negative impact has been widely documented. Considering the complexity of obesity as a chronic disease, general practitioners' role in the assessment and follow-up of obese patients is crucial. In particular, they should set realistic guidelines-based goals, in coordination with the health care network. Our pilot study in one region of Switzerland showed a lack of coherence between guidelines and clinical management of obesity. Improved coordination and education of all health care professionals in this field could increase therapeutic efficacy and solve some of the ethical issues raised by inadequate prescriptions.