This review describes the improvements made in the behavioral treatment of obesity from the 1970s to the present, and then provides a comparable overview of progress that has been made in the behavioral treatment of obese patients with type II diabetes by Wing et al. (13–19) at the University of Pittsburgh. Evidence is presented to show that structured exercise, VLCDs, and intensification of treatment programs may be useful in improving the long-term outcome of behavioral weight-loss interventions.