Obesity is a chronic multifactorial recurrent condition with serious health consequences that contributes significantly to the morbidity and mortality in the population. A positive energy balance, which occurs when food is consumed in an amount exceeding the energy consumption or when energy consumption is reduced, is considered one of the main mechanisms of obesity. The most common type of obesity is exogenous (alimentary-constitutional). There are various pathophysiological determinants of obesity, with adipose tissue playing the most significant role. Non-pharmacological therapies, including lifestyle changes through nutritional correction and increase in physical activity, behavioral therapies aimed at preventing or treating eating disorders, are recommended as the first, mandatory, and continuous stage of obesity treatment. However, the use of non-pharmacological interventions alone is often limited by insufficient effectiveness. Fonturacetam has a promising potential for use in the fight against obesity. The mechanisms of fonturacetam influence on body weight control, energy homeostasis, carbohydrate and fat metabolism, anorexigenic and anti-inflammatory effects showed in studies are the key factors determining the prospects of fonturacetam use in the complex therapy of obesity.