Childhood obesity has become the most common paediatric disorder in the developed world. Treatment of obesity in children may include lifestyle interventions, pharmacotherapy and weight-loss supplements. The outcome of lifestyle interventions, which classically include dietary modifications, increased activity and behavioural modifications, remains insufficient and the adjuvant role of pharmacological agents has been proposed. Among the group of weight-loss medications, orlistat is the only pharmaceutical approved by the US FDA for the treatment of overweight and obese adolescents. The role of metformin needs to be established in larger studies and sibutramine remains an experimental product because of its potential adverse events. Weight-loss supplements lack sufficient data supporting their efficacy and safety, even in adults, and cannot be recommended at this time for adolescents. Preliminary data suggest that the use of fibre supplements, such as glucomannan, provides additional weight loss in individuals receiving a lifestyle intervention. No single approach will successfully treat obesity, and lifestyle modification presently remains the main pillar of any intervention aiming at decreasing bodyweight.