Abstract
Recent secular trends have resulted in large numbers of very overweight children who are at increased risk for type 2 diabetes mellitus and for various coronary heart disease risk factors, including adverse levels of lipids, insulin, and blood pressure. Furthermore, severe overweight in childhood is associated with risk factor clustering and with the initial stages of atherosclerosis. There are also several adult consequences of childhood obesity, including coronary heart disease, type 2 diabetes mellitus, and premature mortality. The difficulties in preventing and reversing obesity, along with the frequent non-adherence of adolescents to lifestyle changes and medical treatment, will complicate treatment and prevention efforts.