We believe that overweight patients defined by BMI criteria need to improve their diet and lifestyle first, but if they suffer from comorbidities, such as metabolic syndrome, prediabetes and hypertension and are not able to lose weight or ameliorate their risk profile through diet and lifestyle alone, anti-obesity drugs, especially GLP1-RA, can already have a role in therapy. This evidence concerns the gene GLP1R and metabolic syndrome.