Obesity is a growing problem worldwide, characterized by the uncontrolled accumulation of fat deposits in the body. Although the etiology of obesity is multifactorial, it most often results from the interaction of environmental factors and genetics. It is necessary to recognize obesity as a disease and treat it as early as possible with an intervention tailored to the individual patient. Pharmacotherapy for obesity, along with reducing caloric intake and increasing physical activity, is an important and effective adjunct in the treatment of obesity. Orlistat, naltrexone/bupropion, liraglutide and semaglutide are the pharmacological options currently available in Croatia. Orlistat achieves its effect by inhibiting gastrointestinal lipases, thereby reducing fat absorption. The effect of orlistat is modest, contributing to up to 3% greater weight loss compared with placebo. In addition, the naltrexone/bupropion combination achieves its effect via the central nervous system. Bupropion stimulates POMC neurons in the hypothalamus, leading to a reduction in food intake and an increase in energy expenditure, while naltrexone enhances the effect of bupropion by activating POMC neurons more strongly and for longer periods of time. Liraglutide and semaglutide are also pharmacologic options for the treatment of obesity. These are GLP-1 agonists whose first indication was the treatment of type 2 diabetes, and only then the treatment of obesity. The above drugs are very effective, with an average reduction in body weight of 6.4% in patients on liraglutide therapy and 15.8% in patients on semaglutide therapy, respectively. Pharmacologic treatment of obesity is an area where there are still new opportunities to be discovered and certainly will be in the future. Among the new future pharmacological options, tirzepatide should be highlighted, whose effect is very promising, with a reduction in body mass of up to 20.9%, thus approaching the results achieved by bariatric surgery.