Obesity remains a leading cause of cardiovascular (CV) 
events and diabetes worldwide. Although there are at least two 
main body-size phenotypes (metabolically healthy and 
metabolically non-healthy) of individuals with established 
obesity, cardiac and metabolic risks amongst these patients’ 
populations extremely distinguishes. The editorial is discussed the 
controversies regarding obese paradox and the probabilities to 
stratify the patients with established obesity in cardiac and 
metabolic risks. It is suggested that the biomarkers could predict 
CV events in patients depending on obese phenotypes. The role of 
metabolic biomarkers, progenitor endothelial cells, natriuretic 
peptides, inflammatory cytokines and galectin-3 are discussed.