The recent 2013 AHA/ACC/The Obesity Society Guideline for the Manage- ment of Overweight and Obesity in Adults underlines the importance of the prevention and treatment of overweight and obesity on risk factors for CVD and type 2 diabetes mellitus, as well as CVD morbidity and mortality, but did not have specific comments on the prevention of HF or treatment of obesity in patients with HF.6 Given the strong association between obesity and incident HF discussed above, it is plausible that intentional weight loss via di- etary intervention, physical activity, approved pharma- cotherapy, or surgery may reduce the incidence of HF, although there are no prospective studies of weight loss specifically studying clinical HF as an outcome (Table 8). Treatment of Obesity in Patients With Established HF Although obesity is not associated with impaired sur- vival in HF, patients with obesity and HF may wish to lose weight for a variety of reasons, including but not limited to improving their quality of life (QOL), improv- ing other medical conditions such as diabetes mellitus or sleep apnea, or in those with advanced disease, im- proving their candidacy for aggressive therapies such as heart transplantation or ventricular assist device place- ment (Table 9). The long-term effect of intentional weight loss in obese patients with HF has not been well studied prospectively. However, a few notable, small, short-term studies of interventions to achieve weight loss, including dietary intervention, physical activity, pharmacotherapy, and surgery, have been performed in populations of obese patients with HF. Dietary Intervention Pilot studies have assessed the safety and feasibility of dietary intervention to achieve weight loss in HF. 