Detailed review of the metabolic consequences of the global epidemic of obesity. Obesity is an exorbitant accumulation of adipose tissue due to a relatively higher calorie intake than expenditure. The major consequence of obesity is the metabolic syndrome, consisting of its initial trigger, insulin resistance, central obesity, decreased levels of HDL-C, increased levels of triglycerides and sdLDL as well as hypertension. The review also discusses the role of chronic low-grade inflammation in obesity. Furthermore, the consequences of atherogenic dyslipidemia, non-alcoholic fatty liver disease and tumor formation are covered.