Cardiovascular diseases and obesity are related medical and social problems. However, some obese people remain free of cardiovascular disease for long periods of time, and the concept of obesity phenotypes that differ in cardiovascular risk has been actively studied. Currently, there are no generally accepted diagnostic criteria for them, and the mechanisms underlying their formation remain unclear. The purpose of this article is to discuss the literature data on obesity phenotypes, their relationship with cardiovascular diseases and mortality, as well as the place of obesity in the domestic algorithm for diagnosing stable coronary heart disease.