Obesity is a serious public health problem in the UK and needs to be tackled both at an environmental and an individual patient level. The Counterweight Project is a structured general practice programme and the first large-scale practice nurse-led intervention aimed at improving the management of obesity in primary care. Preliminary results suggest 40% of patients completing the weight management aspect of the programme achieve and maintain a 5% loss of initial body weight at 12 months. The project is led by a board of consultants from across the UK, is facilitated by dietitians and involves 80 general practices.