<p>The global prevalence of obesity continues to rise. Obesity impacts left ventricular (LV) structure and function through both hemodynamic and metabolic changes and increases the risk of many cardiovascular diseases. Obesity is a significant risk factor for heart failure, particularly HFpEF, and is closely associated with its increasing prevalence, making it a major clinical challenge. Echocardiography, one of the most widely used non-invasive tools for assessing cardiac structure and function, is highly valuable in evaluating cardiovascular complications caused by obesity. Some parameters begin to change already in the overweight stage and allow early detection of cardiac remodeling. Major treatments for obesity include diets, physical activity, bariatric surgery, and pharmacological therapies. Bariatric surgery results in substantial weight loss and improvements in LV structure and function. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have recently been used in obesity treatment, with reports indicating improvements in diastolic function in obese patients. Early and appropriate obesity treatments may help prevent the development of heart failure. This review focuses on the impact of obesity on the heart, the role of advanced echocardiographic evaluation, and the therapeutic effects of bariatric surgery and GLP-1 RAs in improving obesity-related cardiac dysfunction.</p>