Obesity, particularly intra-abdominal (visceral) obesity, is a leading cause of cardiovascular disease (CVD), insulin resistance, type 2 diabetes, dyslipidaemia, inflammation and thrombosis. A useful indicator for visceral fat is waist circumference, which is associated with all-cause mortality. Pro-inflammatory adipokines play a causal role in the development of pathologies associated with insulin resistance, type 2 diabetes and CVD. In addition to established anti-obesity therapies, namely orlistat and sibutramine, a new type of agent that inhibits the cannabinoid receptor (CB1) is advanced in development to reduce appetite and act predominantly against intra-abdominal adiposity.