Obesity is a global health issue with significant economic impact. Lifestyle interventions are the primary approach, with medical therapy as a secondary option. Recent advancements have introduced new therapeutic agents, including GLP-1 receptor agonists (GLP-1 RAs) like semaglutide, liraglutide, and the dual GLP-1/GIP RA tirzepatide, which have shown significant weight loss and metabolic benefits. Bariatric surgery is also effective but has associated risks. Personalized medicine is emerging as a potential future direction. Key therapeutic agents include orlistat, liraglutide, tirzepatide, semaglutide, phentermine/topiramate, naltrexone/bupropion, setmelanotide, metreleptin, sibutramine, rimonabant, lorcaserin, and newer agents under investigation. Bariatric surgery remains a highly effective treatment for weight loss and metabolic improvement, though it has complications. The review highlights the limitations of current treatments, including adverse effects and cost, and emphasizes the need for further research into personalized and combination therapies. Future directions include developing more effective GLP-1 agonists and exploring the role of genetics in obesity treatment. The conclusion emphasizes the importance of integrating various therapeutic approaches to achieve optimal weight loss and metabolic outcomes in obesity management.Obesity is a global health issue with significant economic impact. Lifestyle interventions are the primary approach, with medical therapy as a secondary option. Recent advancements have introduced new therapeutic agents, including GLP-1 receptor agonists (GLP-1 RAs) like semaglutide, liraglutide, and the dual GLP-1/GIP RA tirzepatide, which have shown significant weight loss and metabolic benefits. Bariatric surgery is also effective but has associated risks. Personalized medicine is emerging as a potential future direction. Key therapeutic agents include orlistat, liraglutide, tirzepatide, semaglutide, phentermine/topiramate, naltrexone/bupropion, setmelanotide, metreleptin, sibutramine, rimonabant, lorcaserin, and newer agents under investigation. Bariatric surgery remains a highly effective treatment for weight loss and metabolic improvement, though it has complications. The review highlights the limitations of current treatments, including adverse effects and cost, and emphasizes the need for further research into personalized and combination therapies. Future directions include developing more effective GLP-1 agonists and exploring the role of genetics in obesity treatment. The conclusion emphasizes the importance of integrating various therapeutic approaches to achieve optimal weight loss and metabolic outcomes in obesity management.