Obesity is now recognized as a chronic disease requiring long-term care to treat or prevent adiposity-induced and obesity-related complications. This article discusses the biology of weight regulation as a basis for understanding obesity as a disease, and for appreciating the complex and multifactorial nature of the obesity problem. Finally, the article highlights a clinical approach to obesity care that starts with accurate diagnosis and severity assessment (including clinical vs preclinical obesity), then outlines a multi-pronged treatment strategy, and provides brief updates on pharmacotherapy and the future direction of obesity care.