Most patients with obesity blame themselves, thinking it’s a lifestyle choice — it’s just a matter of hard work and they have failed. A tendency to gain weight is mostly due to genes inherited from parents or other family members, and once the weight is on, the body works hard to keep it on. Dieting can often result in weight loss, but the weight comes back for nearly everyone, and there is a strong chance of ending up heavier than before. Exercise is often tried for weight loss but mostly falls short of patients’ goals. This leads many to dislike exercise or to stop it completely. Sleep deprivation and stress are two causes of obesity that are often overlooked and are areas where patients can often make improvements.