Intensive behavioural therapy is said to be the first line treatment of obesity. The choice of the adjective 'intensive', however, is open to debate. The term 'impactful behavioural therapy' seems more appropriate for the management of persons living with obesity. This refers to a sustained supportive psychosocial intervention, embedded in routine care, designed to modify existing behaviours, and maintain desired ones, in persons living with obesity, and their caregivers, so as to achieve optimal, sustainable weight. The characteristics and contents of such therapy are described in this communication.