Purpose This review summarizes the comprehensive management of obesity with a focus on the pharmacology, efficacy, and safety of anti-obesity medications. Summary Obesity is a highly prevalent chronic disease with significant health risks, requiring a multifaceted approach to treatment. While most approved weight loss medications have modest effects, newer medications such as semaglutide and tirzepatide have shown greater than 15% reduction in baseline weight. Optimal selection of therapy requires taking into consideration patient factors, such as comorbidities and goals, and medication-related factors, including weight loss efficacy, contraindications, and improvements in cardiovascular risk. As the availability of anti-obesity medications increases, multidisciplinary care teams will play an important role in selecting optimal strategies for long-term health benefits in individuals with obesity. Conclusion The expanding array of anti-obesity medications provides valuable treatment options alongside lifestyle interventions and surgical approaches for managing obesity and reducing weight-related health risks. As this therapeutic area continues to grow, selecting optimal agents and educating patients on administration, monitoring, and potential adverse effects will be critical for improving overall outcomes.