Obesity is increasing at an alarming rate worldwide. The majority of obese patients have hypertension, which increases risk for cardiovascular disease. While there is a well-established clinical association, there is an unmet need to better understand integrative molecular and hormonal mechanisms underlying cardiovascular and metabolic derangements in obesity. A failure to consider overlap in the pathways regulating these functions has led to adverse cardiovascular effects of several anti-obesity drugs. This symposium will highlight the need to study integrative cardiometabolic mechanisms in obesity, and will describe potential pharmacologic targets with evidence for positive metabolic and cardiovascular effects in this disease.