OBJECTIVES: The occurrence of obesity in the UK is rapidly increasing, and is associated with significant health problems and economic costs. Despite this, there is currently only one drug recommended by NICE for the treatment of obesity. The purpose of the study was to examine whether the clinical development of obesity treatments is keeping up with the increasing obese population in the UK. METHODS: Adult obesity prevalence data for England were obtained from the 2011 Health Survey for England Trend Tables. Total economic costs were obtained from the National Obesity Observatory. ClinicalTrials.gov was searched for the number of clinical trials investigating drug and device interventions for obesity initiated yearly from database inception to the 17th of January 2013. Results were reviewed to exclude trials investigating dietary supplements, behavioural changes, dietary changes, and those without a UK centre.   RESULTS: The prevalence of obese adults in England has risen from 14.9% (1993) to 24.8% (2011). This has been associated with an estimated increase in total costs to the UK of £2.6 billion (1998) to £15.8 billion (2007). Since 2000, 46 trials have been initiated investigating treatments for obesity. The number of clinical trials initiated yearly has increased since 2000; however recent years have seen a decline. 1 trial was initiated in 2000, generally increasing up until 2010 when 8 trials were initiated. 2011 and 2012 both saw a dip in the number of initiated trials, with only 3 trials started in 2012. CONCLUSIONS: The prevalence and economic burden of obesity has increased drastically in the UK over the past 18 years. The rate of clinical development has also increased; however, this rate is low in relation to the significance of this health problem and the increase in the obese population. These results highlight the need for further clinical development in treating obesity.