Obesity is a chronic condition associated with multiple significant adverse health outcomes. Recent decades have seen dramatic increases in obesity rates across much of the globe and it now represents one of the foremost challenges facing healthcare systems. Within the New Zealand context, over a third of adults are now classified as obese, with particularly high rates in Maori and Pacific communities. Te Mana Ki Tua is a specialist weight management service established in South Auckland in 2023. The service utilises non-surgical approaches to complex obesity including low energy diets and weight management medications. This presentation covers the non-surgical management of obesity and the experience of our service to date. I will also discuss where the novel anti-obesity medications sit alongside established surgical interventions and the future of this area.