Lipid peroxidation is believed to be the major biochemical alteration underling oxidant-induced cell injury in stress including numerous diseases. One of the natural molecules known to prevent or retardate oxidation is α-lipoic acid (α-LA) thus, the lipoic acid/dihydrolipoic acid (LA/DHLA) redox couple has received considerable attention. Recent studies highlighted the potential of free LA and DHLA as powerful metabolic antioxidants that are able to scavenge the reactive oxygen species and to recycle other antioxidants. Our aim was to investigate the effects of α-LA in the treatment of Italian pre-obese and obese patients. 1612 people were enrolled and 1127 of them (445 men and 682 women, 18-60 age) met criteria and were screened in the study. According to body mass index (BMI), 53% of them were obese, and 43% were pre-obese. They were treated for 4 months with 800 mg/day of α-LA. In the pre-obese group, significant reductions (p < 0.001) of weight (8%, in both gender), BMI (2 points), blood pressure, and abdominal circumference (female 6 cm, male 7 cm) were observed. In the obese group, significant reductions (p < 0.001) of weight (9%, in both gender), BMI (female 3 point, male 4 point), blood pressure and abdominal circumference (female 9 cm, male 11 cm) were highlighted. Our study indicated that α-LA is an ideal antioxidant candidate for the therapy of obesity related diseases. Further clinical studies should be considered to demonstrate the role and efficacy of α-LA treatment.