Obesity is at an epidemic level. All patients who are overweight and obese should be treated with diet, exercise, behavioral therapy or a combination thereof; however, these therapies may not be adequate for a number of patients. Pharmacotherapy should be considered for patients who are obese, are overweight with cardiovascular risk factors, or have failed standard therapy. Several medications, such as phentermine and diethylpropion for short-term treatment as well as sibutramine and orlistat for long-term treatment, are currently available. There are also off-label uses of other medications such as antidepressants, anticonvulsants, and anti-diabetic medications, for the management of obesity. All of these medications provide additional weight loss when used as an adjunct to the standard therapy of lifestyle modification. The objective of this review is to summarize different patents and new approaches in the treatment of obesity.