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Rising rates of obesity and the resultant increase in associated cardiometabolic morbidity and mortality provided impetus for a roundtable discussion by an expert panel of physicians, physician assistants, and other scientists. Panel members reached a consensus concluding that obesity itself, as defined by waist circumference and the presence of comorbidities, is a disease that should be recognized and addressed with appropriate therapy. Their consensus is based on discussion including evidence that supports obesity, particularly central obesity, best measured by waist circumference, as a risk factor for cardiometabolic diseases. Waist circumferences greater than 102 cm (>40 inches) for men and greater than 88 cm (>35 inches) for women portend high risk. The expert panel endorses three levels of options for management: lifestyle modification, pharmacotherapy, and surgery. Panel members recommend the use of antiobesity agents and acknowledge that the benefits outweigh the risks associated with surgical procedures for obesity. They also point to the need to develop risk stratification guidelines for intervention targeting obesity as a disease.