[Obesity: one of this century's greatest health challenge?].

The prevalence of overweight and obesity exceed 50% in many European countries. Obesity is responsible for 2-8% of all health costs and 10-13% of all deaths in Europe. Only a fraction of patients obtain a medically relevant weight loss of 5-10% through lifestyle intervention. Surgery is limited to severe obesity and is very costly; therefore pharmaceuticals are a relevant alternative. Such treatment is hampered by the lack of official guidelines and a relatively limited effect compared to the expectations of patients as well as medical staff. Guidelines and official subsidies are debated.