The recent reimbursement of semaglutide and the recent RCT on tirzepatide for obesity sparks the discussion on the role of the Dutch general practitioner (GP) in lifestyle counselling. This discussion is also stimulated by recent reports and position papers of various influential institutions. Given a recent systematic review that shows the effectiveness of lifestyle counselling in primary care this should be considered and also more developed in the Netherlands. GPs need to formulate their needs regarding the facilities that they require to perform and refer for lifestyle counselling. In addition, policy makers need to work on a healthy lifestyle-stimulating environment. More research is needed to better tailor lifestyle interventions. Also more knowledge is needed on long-term side-effects and hard endpoints for medication. GP need to go for lifestyle and reserve medication for a small selected group of patients with severe obesity.