I have noticed that a patient’s main problem in not regaining the weight (after significant weight loss) is not ignorance of healthy eating or of the health benefits of physical activity; rather it is an issue of establishing new routines, solving practical problems, and changing a pattern of emotional eating. This is why I emphasize the importance of changing behaviors, creating new habits, learning to cope with stress and find solutions to their everyday problems. Expecting weight maintenance from a patient without including it in my weight reduction program is like expecting somebody to perform the lead part in Swan Lake by giving them a pair of ballet shoes but no training.