What treatment options exist for obesity or being significantly overweight besides medication?

There's a range: structured lifestyle programs (nutrition and activity coaching, often with a dietitian), behavioural therapy for eating patterns, and for higher BMI categories or specific health situations, bariatric surgery. Sleep and stress management are also increasingly recognized as part of a full treatment approach rather than side notes. These aren't mutually exclusive with medication either. Most current guidelines frame medication as one tool alongside these, not a replacement for all of them. References: https://obesitycanada.ca/healthcare-professionals/adult-clinical-practice-guideline/