Obesity is a chronic and progressive disease that has become a major public health issue, associated with various comorbidities and increased mortality. Lifestyle interventions and bariatric surgery are not suitable or effective for all patients. Anti-obesity medications (AOMs) have historically achieved mean weight loss of 5-10%, but their efficacy and long-term use have been limited due to concerns about safety and stigmatization. Semaglutide, a newer GLP-1 receptor agonist, has shown significant weight loss, with a mean of 15% and a substantial proportion of patients losing over 20%. This review discusses the current landscape of AOMs, the results of semaglutide, and future perspectives on obesity treatment. Key AOMs include orlistat, sibutramine, phentermine, naltrexone-bupropion, phentermine-topiramate, liraglutide, and semaglutide. Each drug's efficacy, safety, and clinical impact are evaluated, highlighting the potential of semaglutide to bridge the gap between patient expectations and treatment outcomes. The review also addresses the challenges and concerns associated with long-term use of AOMs, emphasizing the need for a chronic disease management approach to obesity.Obesity is a chronic and progressive disease that has become a major public health issue, associated with various comorbidities and increased mortality. Lifestyle interventions and bariatric surgery are not suitable or effective for all patients. Anti-obesity medications (AOMs) have historically achieved mean weight loss of 5-10%, but their efficacy and long-term use have been limited due to concerns about safety and stigmatization. Semaglutide, a newer GLP-1 receptor agonist, has shown significant weight loss, with a mean of 15% and a substantial proportion of patients losing over 20%. This review discusses the current landscape of AOMs, the results of semaglutide, and future perspectives on obesity treatment. Key AOMs include orlistat, sibutramine, phentermine, naltrexone-bupropion, phentermine-topiramate, liraglutide, and semaglutide. Each drug's efficacy, safety, and clinical impact are evaluated, highlighting the potential of semaglutide to bridge the gap between patient expectations and treatment outcomes. The review also addresses the challenges and concerns associated with long-term use of AOMs, emphasizing the need for a chronic disease management approach to obesity.