The first line in the treatment of obesity is a combination of a low calorie diet, increased physical activity and behavioural therapy. Unless these options fail, should be considered an effective and safe pharmacotherapy. The market situation in anti-obesity treatment will change in a relatively short time; the combination anti-obesity therapy is entering into clinical practice. Currently in Europe we have three drugs approved for long-term chronic treatment of obesity. In addition to the orlistat EMA approved a combination of naltrexon SR/bupropion SR and liraglutide 3.0 mg. A specific feature management of obese diabetic patients is the selection of weight neutral or weight-reducing anti-diabetic treatment (oral anti-diabetics, insulin), but also weight neutral treatment associated with co-morbidities.