The prevalence of obesity has increased over the last few decades reaching epidemic proportions. Tt is well-known that obesity, as measured by body mass index (BMI), is related to the development of cardiovascular outcomes. However, a very intriguing topic is being discussed. In patients with established HF, accumulating evidence suggests that overweight and obese (higher BMI) individuals have improved survival compared to those with normal BMI, a known concept which has been called the “obesity paradox”.