Adolescent obesity has reached epidemic proportions in the U.S.A in recent years. This epidemic has been accompanied by an increased risk of cardiovascular disease (CVD), diabetes, and hypertension. Safe and effective interventions to treat and prevent obesity and CVD risk factors are needed. Family physicians can play a critical role in managing weight control and cholesterol levels in adolescents. A significant reduction was noted in total cholesterol (-26.2%), total cholesterol/HDL-C ratios (-25%), LDL-C (-31%), and triacylglycerol (-48%), and triacylglycerol/ HDL-C ratios (-42%); all p <. 05. There was no significant change in HDL-C. In 9 to 16-year-olds on the Pritikin Program, which included a high-fiber and low-fat diet coupled with daily activity over a 2-week period, we noted significant weight loss and significant reductions in total cholesterol/HDL and triacylglycerol/HDL ratios, and total cholesterol, SDS-C, and triacylglycerol without significantly decreasing HDL-C. This intervention in 9 to 16-year-olds differs from the recent recommendations provided by the American Heart Association (AHA) for children in only one regard: only 15-20% of calories were provided by fat in this intervention. This is in contrast to the AHA recommendation for children to consume less than 20% and no more than 30% of calories from fat. The concern has been that a very low-fat, high-carbohydrate diet could lower HDL and raise triacylglycerol levels. However, our data does not support these concerns, and suggests that a very low-fat, high-fiber diet combined with adequate activity can provide a substantial improvement in the overall lipid profile and also lower triacylglycerol levels.