Purpose of review To discuss and gather together current knowledge pertaining to the role of dopaminergic neurotransmission in the control of various metabolic and behavioural processes that are often disrupted in obese humans, and to highlight evidence that dopaminergic drugs can ameliorate various metabolic anomalies associated with obesity. Recent findings Dopamine is involved in the control of food intake, energy expenditure, glucose and lipid metabolism, blood pressure and insulin release. Dopaminergic (D2 receptor) neurotransmission is diminished in the brains of obese animal models and humans. D2 receptor activation facilitates glucose metabolism, lowers blood pressure and stimulates resting energy expenditure in non-diabetic obese individuals. Long-term treatment with D2 receptor agonists improves metabolic control in obese humans with type 2 diabetes. Summary The (re)activation of diminished D2 receptor-mediated neurotransmission simultaneously ameliorates a number of metabolic anomalies associated with obesity in humans. D2 receptor agonistic drugs could be an asset to our armamentarium in the battle against type 2 diabetes and cardiovascular disease. Their clinical efficacy may, however, be curtailed by the fact that D2 receptors are less abundant in obesity. The (patho-)biology of dopaminergic neurotransmission in obese individuals thus requires further study to be able to design drugs that can boost the beneficial effects of D2 receptor agonists in obese humans.