Over the last few decades, from being a purely esthetic problem without any pathological implications, obesity has become a true epidemic affecting more than a third of the Western population, involving an increasing number of people among the younger generations. Obesity is characterized by a myriad of metabolic derangements, in which adipose tissue plays a key role and has shown to be one of the most complex and fascinating endocrine organs discovered recently. Adipose tissue, whose essential role is to store the energy required to support metabolism and contribute to immunologic and reproductive functions, is compromised by genetic and environmental influences, which turn it into a dysfunctional tissue. Visceral adipose tissue in obesity is characterized by morphologic and functional changes that turn it into a source of cytokines directly produced by adipocytes. These are currently known as adipokynes,