In this brief review published in the latest edition of Hypertension, Harmancey et al. discuss the harmful effects of obesity and its associated metabolic perturbations on the physiology and the substrate metabolism of the heart. They suggest that cardiac function may be abnormal in individuals with excess body weight and that the mechanisms linking obesity with cardiac function appear to be potentially independent from blood pressure. As obesity is associated with elevated circulating levels of free fatty acids (FFA), increased FFA delivery to the heart might considerably perturb fat oxidation processes, which could cause accumulation of products that have the potential to alter contractile function. The authors also suggested that there are several additional mechanisms by which cardiac function is impaired in obesity. Thus, a great deal of research will be required to fully elucidate the pathophysiological mechanisms surrounding so-called “obesity cardiomyopathy.”