Abstract: The persistence of obesity is rooted in energy storage mechanisms formed through millions of years of evolution, combined with the systematic influence of the modern "obesogenic environment", constituting a complex regulatory network involving coordinated neural, endocrine, and metabolic systems. Current mainstream treatment methods exhibit significant limitations: glucagon-like peptide‑1 receptor agonists demonstrate remarkable short‑term weight loss effects but present issues with tolerance development and post‑discontinuation weight regain; bariatric metabolic surgery similarly faces long‑term weight recurrence challenges, with approximately one-third of patients experiencing weight regain within five years after surgery. Therefore, comprehen-sive obesity treatment must establish a new paradigmatic framework: utilizing cognitive behavioral intervention as the therapeutic foundation, employing multi‑dimensional strategies including mindful eating training, nutritional management, and exercise intervention to help patients establish sustain-able lifestyle changes; repositioning pharmaceutical and surgical medical interventions as supportive measures for behavioral change; constructing multi‑level social support environments encompassing policy, community, and family domains to achieve transformation from treatment goals focused solely on weight reduction to metabolic health improvement, from success definition based on short-term weight loss to long‑term maintenance, and from medical‑dominated treatment systems to patient‑centered multidisciplinary collaborative approaches. Ultimately, through the deep integration of biomedical precision, patient cognitive initiative, and social support inclusiveness, a sustainable collaborative pathway for obesity treatment can be established. Based on twenty years of clinical experience in bariatric and metabolic surgery, the authors provide an in‑depth analysis of the treat-ment challenges faced by obesity as a complex disease and proposes the necessity of transitioning from traditional single medical interventions to a biopsychosocial comprehensive treatment model.