The problem of obesity has grown to an alarming level in many parts of the world. It is a challenging health issue that requires understanding not only the pathophysiology but also the cultural and psycho-social issues that contribute to its spread. It is difficult to treat, and no quick fix is available. The evolution of obesity treatment has gone through various phases during the last few decades. A multidisciplinary approach is a current standard. Several medical and surgical options have evolved to tackle the challenges brought on by obesity. Established bariatric surgical procedures include adjustable gastric banding, Sleeve gastrectomy, Roux N Y gastric bypass and duodenal switch with biliopancreatic diversion. Recently approved devices and procedures include intragastric balloons, vagal nerve blockade (Vbloc) and AspireAssist. Several medications have also been approved to treat this disease. A lot of emphases is given to the lifestyle changes. Counseling and behavioral modification remain an integral part of any bariatric program. In the absence of lifestyle changes, the most aggressive form of bariatric surgery may not succeed, and patients may gain weight. Similarly, medications to treat obesity may not work if patients do not have the will to change. An emerging trend is the convergence of medical and surgical tracks while addressing the problem of obesity. Many bariatric surgery patients could benefit from weight loss medications at various stages of their treatments along with behavior modification to help maintain weight loss.There is increasing interest in the medical community and general population to learn more about this health issue. Increasing number of physicians are now taking the obesity board certification exam.