Obesity and metabolic diseases represent a major problem for our society. For this reason, a number of medical, behavioral, hygienic-dietetic and surgical therapies have been used in an attempt to solve or palliate this problem. In these last years, we have seen a growing number of endoscopic therapies directly targeted to treat obesity and its complications, and its clinical usefulness is relatively unknown. The current review attempts to update what is known on the different endoscopic therapies for obesity, paying special attention to technical aspects and the existing evidence of their usefulness in clinical practice.