Obesity is a chronic, recurring, progressive disease with significant public health implications, including increased risk of various comorbidities and mortality. Lifestyle interventions alone provide limited long-term weight loss, and bariatric surgery is not suitable for all patients. Anti-obesity medications (AOMs) have historically shown limited efficacy, but newer drugs like semaglutide have significantly improved weight loss outcomes. Semaglutide, a GLP-1 receptor agonist, has shown mean weight loss of up to 15% in phase 3 trials, with some patients losing over 20%. This has changed the landscape of obesity treatment, bridging the gap between patient expectations and clinical results. Current AOMs include orlistat, sibutramine, phentermine, and combinations like naltrexone plus bupropion and phentermine plus topiramate. These drugs have varying efficacy and safety profiles. Semaglutide has shown superior weight loss compared to other AOMs, with significant improvements in body weight, body composition, and cardiometabolic risk factors. It is approved for obesity treatment in the US, Europe, and Brazil. Other drugs like liraglutide and tirzepatide are also being studied for obesity treatment. The STEP program demonstrated that semaglutide can achieve significant and sustained weight loss, with long-term benefits. The results highlight the potential of semaglutide and other newer drugs to improve obesity treatment outcomes.Obesity is a chronic, recurring, progressive disease with significant public health implications, including increased risk of various comorbidities and mortality. Lifestyle interventions alone provide limited long-term weight loss, and bariatric surgery is not suitable for all patients. Anti-obesity medications (AOMs) have historically shown limited efficacy, but newer drugs like semaglutide have significantly improved weight loss outcomes. Semaglutide, a GLP-1 receptor agonist, has shown mean weight loss of up to 15% in phase 3 trials, with some patients losing over 20%. This has changed the landscape of obesity treatment, bridging the gap between patient expectations and clinical results. Current AOMs include orlistat, sibutramine, phentermine, and combinations like naltrexone plus bupropion and phentermine plus topiramate. These drugs have varying efficacy and safety profiles. Semaglutide has shown superior weight loss compared to other AOMs, with significant improvements in body weight, body composition, and cardiometabolic risk factors. It is approved for obesity treatment in the US, Europe, and Brazil. Other drugs like liraglutide and tirzepatide are also being studied for obesity treatment. The STEP program demonstrated that semaglutide can achieve significant and sustained weight loss, with long-term benefits. The results highlight the potential of semaglutide and other newer drugs to improve obesity treatment outcomes.