The pharmacotherapy of obesity has historically recorded an overall poor safety 
and efficacy profile largely because of the complex mechanisms involved in the 
pathophysiology of obesity. It is hoped that a better understanding of the 
regulation of body weight will lead us to the development of effective and safer 
drugs. Recent advances in our understanding of the regulation of energy 
homeostasis has allowed the design of novel anti-obesity drugs targeting 
specific molecules crucial for the modulation of energy balance, including drugs 
that induce satiety, modulate nutrient absorption or influence metabolism or 
lipogenesis. Almost a decade after the Food and Drug Administration approved the 
first weight loss medication, it recently approved two novel anti-obesity drugs 
Belviq (lorcaserin) and Qsymia (topiramate and phentermine), thus signalling the 
beginning of a new era in the pharmacotherapy of obesity. It is believed that 
the next generation of weight-loss drugs will be based on combination treatments 
with gut hormones in a manner that mimics the changes underlying surgically 
induced weight loss thus introducing the so called 'bariatric pharmacotherapy'. 
An in-depth understanding of the interrelated physiological and behavioural 
effects of these new molecules together with the development of new treatment 
paradigms is needed so that future disappointments in the field of obesity 
pharmacotherapy may be avoided.