The obesity epidemic has reached unprecedented proportions in Western society. Evidence continues to accumulate that obesity is associated with significant morbidity and mortality and in particular that it is an independent risk factor for cardiovascular disease (CVD). The association of obesity with CVD and its risk factors, including hypertension, dyslipidemia, glucose intolerance, and impaired hemostasis is becoming more clearly understood. An increasing body of data indicates that risk factors tend to cluster in obese individuals and may act synergistically to increase these people's risk for CVD. Individuals with disproportionate visceral adiposity are at significantly greater risk for CVD. Adult weight gain also underlies the development of many risk factors and augments the risk of CVD. Physicians can play a vital and active role in the prevention and treatment of obesity and overweight and thereby reduce patients' CVD risk.