One of the members of the Growing Healthy Families sessions, at the Anacostia Library ,has lost over 100 pounds through a variety of lifestyle changes. This weekly class, by 5 A DAY CSA, emphasizes vegetable and fruit intake as part of a healthy plate, as well as other lifestyle changes. We discuss the challenges of eating a balanced diet in food deserts ,and the dense landscape of fast food outlets in food swarms. For some with extreme obesity, bariatric surgery can help manage obesity as well as uncontrolled Type 2 diabetes , and heart disease. The basis of all options in obesity management, however, require lifestyle changes that remain elusive for some.