Obesity is a highly prevalent and complex chronic disease associated with numerous comorbidities. Treatments include lifestyle modification, pharmacotherapy and surgery. Before beginning therapy, it is important to identify and address potential barriers to weight loss. Weight reductions of 5‐10% are clinically beneficial and improve some obesity related comorbidities. After one year, lifestyle modification reduces weight by about 3‐5 kg and pharmacotherapy lowers weight by an additional 3‐5 kg. High attrition rates and poor long‐term persistence with treatment are the major limitations to non‐surgical treatment. Bariatric surgery is the most efficacious treatment available for the severely obese but is often difficult to access in public health systems. Surgery reduces mortality by 30% and markedly improves comorbidity in predominantly observational studies and highly selected patient populations.