Obesity, defined as a body mass index (BMI) of at least 30 kg/m² is at epidemic proportions.

The World Health Organization estimates that 300 million people world wide are obese and an additional 700 million are overweight (BMI 27-29.9). Obesity and overweight are responsible for substantial morbidity and carry a high risk for cardiovascular disease, hypertension, stroke, type 2 diabetes, and some forms of cancer. Obesity is also an important cause of premature death.

The few drugs currently approved for the long term management of weight loss in obese and overweight individuals are compromised by poor efficacy and poor tolerability.

New anti-obesity agents that are effective and well tolerated are urgently needed. Several novel agents are in late stage clinical development; many of these agents target newly identified pathways, yet they lead to only modest weight loss in the majority of obese subjects. Paradigms for treating obesity are changing and will likely include the use of multiple agents that modulate different systems in addition to diet, exercise and other lifestyle changes to induce meaningful and sustained weight loss to reduce the morbidity and mortality associated with obesity.

Surgical approaches for obesity have become more common, less dangerous and more acceptable to both patients and their physicians. These procedures are generally reserved for the most severely obese and those with significant obesity related comorbid diseases. The effects of these procedures on weight loss and the reduction of obesity related comorbid illness can be profound, however they are associated with significant risks.

The increasing availability of these procedures will likely increase awareness of obesity and its treatment options. The increasing awareness of obesity as a disease, a greater number of therapeutic choices, and the rapidly advancing understanding of its causes make the future very promising for the development of effective obesity therapeutics.