Obesity is a chronic disease with significant secondary diseases such as type 2 diabetes mellitus, lipometabolic disorders and high blood pressure. New pharmacological approaches have significantly expanded the treatment options. GLP-1 receptor agonists such as semaglutide (Ozempic®, Wegovy®) or dulaglutide (Trulicity®) were originally developed for the treatment of type 2 diabetes, but also show a significant weight reduction of up to 15 % of the initial weight. Newer substances such as tirzepatide even enable weight loss of up to 25 % in studies. The mechanism of action is based on an inhibition of the feeling of hunger, delayed gastric emptying and an improved insulin effect. The therapy is usually given as a weekly subcutaneous injection and must be gradually increased in dosage to minimize gastrointestinal side effects such as nausea or diarrhoea. Simultaneous lifestyle modification with dietary changes and physical activity is important, as rapid weight gain often occurs after discontinuation of the medication. The treatment is approved for patients with obesity (BMI ≥ 30) or overweight (BMI ≥ 27) and at least one concomitant disease. This modern drug therapy is a promising addition to proven conservative measures and offers a new glimmer of hope for severely overweight patients.