Objective. To evaluate current approaches to the treatment of obesity grade I in the Russian Federation and associated risks of arterial hypertension, type 2 diabetes mellitus, dyslipidemia, cardiovascular events (myocardial infarction and stroke) considering real clinical practice data. Material and methods. We performed an observational retrospective study using «Webiomed» predictive analytics platform con-tained anonymized electronic records of patients from medical information systems of various hospitals and regions of the Russian Federation between 1999 and 2022. We assessed 10-year risk of hypertension, type 2 diabetes, dyslipidemia, and cardiovascular events (myocardial infarction and stroke) in 59,427 patients aged 18—50 years with obesity grade I. We studied treatment approaches for obesity grade I and type 2 diabetes in real clinical practice. Results. There were high 10-year risks of arterial hypertension (OR 1.81; 95% CI 1.7751; 1.8594; p