Obesity in childhood and adolescence

3The rise in the cardiovascular death rate is explained by the increased risk factor profile from high rates of hypertension, dyslipidaemia, type 2 diabetes and sleep apnoea. 4 Longitudinal studies looking at various risk factors, including carotid intima-media thickness, have indicated that adults who became obese but had a normal BMI in childhood had a more adverse risk profile. Adults who were obese as children and then normalised their BMI had a risk profile similar to patients who had never been obese during childhood. 5 Given the above, active intervention in childhood obesity is likely to have a number of benefits. However, we face the difficult scientific problem that circulating levels of biological mediators of appetite which encourage weight regain after induced weight loss do not revert to the levels recorded before weight loss. 6 Long-term strategies and research to counteract this change are needed to prevent obesity relapse, and so far we have failed in this area. Various other factors have contributed to our lack of success in containing childhood obesity, including living in neighbourhoods with a high level of poverty, 7