Obesity is a chronic disease associated with a number of co-morbidities. Management options include lifestyle changes, pharmacotherapy and bariatric surgery. European guidelines recommend the use of pharmacotherapy for BMI ≥30 kg/m2 or BMI ≥27 kg/m2 with comorbidities in adjunct to lifestyle modification. Until 2015, orlistat was the only available medication for the treatment of obesity in Europe. Since then, further pharmacological agents have been approved, including the GLP-1 agonist liraglutide 3 mg (Saxenda) and the combination of Naltrexone/Bupropion (Mysimba). In the USA, the repertoire of approved drugs is more extensive, and includes drugs such as the 5HT2C receptor agonist Lorcaserin (Belvic) and the combination of Phentermine/Topiramate (Qsymia). Each of these medications has a unique mode of action and promotes weight loss by targeting hunger and satiety pathways in the brain. The lecture will review mode of action, efficacy and side effects of these new pharmacotherapies. Clinical trial data will be shown to discuss how early response to pharmacotherapy can be predictive of clinically meaningful weight loss long-term for remission of obesity related co-morbidities. New potential pharmacotherapies based on GLP-1/glucagon receptor co-agonism will be briefly discussed.