Context. Obesity is increasing at an alarming rate. During the past de
cade, the overall prevalence of obesity in the United States increased
over 30%, with more than one third of the adult population meeting th
e definition of being overweight. Objective, We review current and eme
rging therapies, present outcome data from a lar ge clinical practice,
and discuss challenges for physicians and researchers involved in obe
sity treatment. Summary. Because obesity is a risk factor for numerous
medical disorders and excess mortality, it is imperative that effecti
ve treatments be developed. While the current conservative therapies p
roduce short-term weight losses, they are ineffective in the long term
. Some obesity treatments are controversial, most notably the increasi
ng use of anorexiant medications. For example, the Food and Drug Admin
istration (FDA) recently requested the withdrawal of two widely used m
edications because of concerns about side effects. Currently, therapie
s that combine psychosocial interventions, drugs, and extended mainten
ance appear to have the most promising long-term benefits. Conclusions
. Long-term treatment, including extended pharmacotherapy, may be nece
ssary for many obese patients. Broader definitions of treatment outcom
e and success, including improvements in comet-bid conditions, physica
l activity, and quality of life are needed.