Given the rapid increase in the prevalence of overweight, obesity, type 2 diabetes and other obesity-related conditions across the world, despite a plethora of evidence-based guidance for clinicians, innovative campaigns aimed at the general public and widespread government public health initiatives, it is clear that a novel approach is required. The importance of fluid intake has been overlooked in campaigns and guidelines and also in the clinical setting, where the question ‘what do you drink?’ is often omitted. It is a significant oversight that food pyramids and healthy-eating plates across the world omit fluids from their graphics and advice. While guidelines include recommendations on changes in physical activity and diet, often little or no advice is offered on the importance of healthier hydration practices, neglecting to highlight the contribution of beverages high in sugar, alcohol or additives. An interdisciplinary group of experts in medicine, nutrition, physiology and public health discussed issues surrounding healthy-hydration practices in March 2010 in Paris to create a consensus statement on hydration and gain of body weight and provide recommendations.