A 12-wk weight-management program was conducted to test the effectiveness of a combined very-low-calorie diet (VLCD) [2.0 MJ/d (470 kcal/d)] (week 1-5) and exercise (E) program supervised by each patient's general practitioner and dietitian. Throughout the program, patients [body mass index measured in kg/m2 (BMI) 27-35] were encouraged to take part in an individually graded E program of walking (W), cycling (C), running (R), or swimming (S) (Van Baak and Binkhorst 1981). Ninety-four patients (65 female and 29 male, weight: 87.7 kg, BMI: 30.7, age: 39.8 y) completed the program (delta: -10.6 kg). At the start, 46% were not involved in any type of physical exercise. After 12 wk only 8% were inactive (Drop out group (n = 14): 47%). Weight loss over 12 wk was significantly (P less than 0.01) related to participation rate in the E program. Also, 24-wk follow-up showed a significantly better (P less than 0.05) weight maintenance for patients who continued the E program (+0.4 vs +1.8 kg). These data demonstrate the effectiveness of a weight-management program including exercise in primary health care.