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Obesity continues to increase dramatically in both industrialized and nonindustrialized countries. The scope of the problem in Hispanic populations follows a similar epidemic pattern to industrialized countries, but the unfavorable social and economic features of these populations have placed them at increased risk of developing cardiometabolic syndrome and cardiovascular disease. Some pathophysiologic elements of obesity appear to have a differential biologic behavior in these populations, suggesting that not only environmental factors, but also genetically determined conditions, can influence obesity-related cardiometabolic risk. However, the high epidemiologic diversity of these populations and the lack of reliable statistics make it difficult to ascertain the characteristics of obesity in Hispanics, especially as most of the available data come from Hispanics living in industrialized countries. The management of obesity in Hispanic populations is similar to that in non-Hispanics, and is based on lifestyle changes, weight-reducing medication and bariatric surgery. Novel research related to gut-derived hormones and the endocannabinoid network will potentially contribute to treat obesity better. Newer studies taking into account ethnic differences will result in improved therapeutic alternatives for the prevention of obesity and cardiometabolic syndrome-related cardiovascular disease if they can be coupled with improved living conditions.