Obesity is a complex malrelationship between energy intake and expenditure that results in a homeostasis that is resistant to change. Obesity clearly has negative health implications that are well documented in consensus literature. Likewise, correction of body weight reduces the incidence and severity of comorbid diseases. A key aspect to this end is a significant amount of physical activity that is appropriately supervised and quantified. The objective of this review was not so much to explore the intricate physiologic details of the treatment of obesity but rather to provide an overview of the preparticipation assessment and practical application of an exercise program for the treatment of obese patients. Many physicians never broach this subject with their patients because of time limitations or comfort-level constraints. This is unfortunate because a physician's recommendations and proper guidance at the point of care are important predictors of patient participation in exercise