This condition is generally a whole person issue, not just a physical weight problem. Apart from some conditions where hormonal imbalance is the prime causative factor, there are invariably psycho-social reasons why a person gains or loses weight. It is essential to explore these reasons, as it otherwise can become a remittent condition that can debilitate health mentally and emotionally. The most effective approach is an integrative and participatory one whereby lifestyle and emotional factors are addressed together with a metabolic treatment programme that corrects biological imbalances.