Obesity is a common medical problem that is growing in both numbers of patients and cost to the healthcare system. In addition, the disabilities associated with obesity can have significant impact on a patient's quality of life. The interventions to date for treating obesity are generally divided into 2 categories: conservative (diet, exercise, behavioral management, and pharmacology) and surgical. The success rate of conservative management has been modest, at best. Surgical therapy, which can create enduring and significant weight loss in some situations, has its associated morbidity, mortality, and cost. Surgical therapy is not appropriate for someone seeking to lose a modest amount of weight. Internationally, endoscopic devices for obesity are available. Published reports have demonstrated some success in obtaining weight loss with these endoscopic devices. The most common is the intragastric balloon. Other endoscopic obesity devices are in development. These devices may play a role in weight loss therapy and serve as part of the therapeutic continuum between conservative management and surgery that clinicians and patients can choose from for the treatment of obesity.