Obesity in children has increased dramatically over the past few decades, becoming a major public health concern worldwide. Effective treatments must be implemented to reduce the burdens related to diabetes, cardiovascular disease, and mortality associated with obesity. While lifestyle interventions, such as diet and exercise, are often the first-line treatment for obesity, additional approaches may also be necessary for some individuals. Medications can help individuals achieve significant weight loss targets. This review aims to investigate the potential of pharmacological treatments for managing obesity in children, both currently available and future approaches. This article will discuss utilizing current molecular understanding to develop appropriate pharmacotherapeutic approaches that can lead to improved therapeutic outcomes. This review of anti-obesity drugs evaluates current therapies such as orlistat, which inhibits gastrointestinal lipases and reduces dietary fat absorption. Phentermine suppresses the appetite through the augmentation of norepinephrine levels. Liraglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist that influences appetite regulation and glucose metabolism. Setmelanotide is a synthetic analog of α-melanocyte-stimulating hormone (α-MSH) that acts as a potent melanocortin receptor (MC4R) agonist, which promotes feelings of fullness and reduces appetite. Overall, only a limited number of anti-obesity drugs are approved for children. More research is necessary to evaluate the efficacy and safety of currently available drugs for pediatric obesity. In the future, developing safe and effective pharmacological interventions that target different mechanisms of action for childhood obesity is an important area of research that can potentially improve the health outcomes of millions of children worldwide.