Obesity and Venous disease (Varicose veins): Weight management in venous disease (varicose veins) patients is very difficult. It is becoming a common problem in the vascular surgery out patient clinics. Some may still feel that obesity is not a major problem in Indian hospitals. In the venous subset of population attending the vascular clinics this is a significant problem. A recent study by the University of Maryland and the National Council of Applied Economic Research found 22 per cent of Indians living in cities were overweight and 7 per cent were obese. The following is the typical presentation in our clinic. Here is a man weighing 107 Kgs with history of bleeding from the leg veins. He was advised to loose 5 kgs by adjusting diet and life styles along with class II stockings. He came back to the clinic after 4 weeks with a weight of 110Kgs. But he is regular with his stockings and there were no episodes of bleeding from the leg. This is a common problem to see weight gain when you advise them to loose weight. Weight management needs special attention to the details and it would not be sufficient if we simply advice the patients to loose weight. Very few patients (from low socioeconomic group) succeed in loosing the weight with a simple advice in the outpatient clinics. India has 70 million people who have been re-classified as overweight or obese, after a lowering of obesity thresholds. In India the BMI limits have been lowered to 23 for being overweight and 25 for being obese, to reflect the risks to the population. Indians also have lower thresholds for waist circumference measurements.