Overnutrition in the form of unusual fatness has been recognized over the ages and in all societies. In the past, fatness was usually seen as a sign of health, opulence and/or fertility. Today we know that obesity tends to be accompanied by a number of adverse health risks, and obese individuals are too often viewed as figures either of fun or of dislike. Yet, for all the health disadvantages and social opprobrium, obesity and overweight are developing in epidemic proportions in the westernized developed world. We recognize this epidemic in the need to enlarge and reinforce seats in theatres and aeroplanes and in the need for change in clothing styles and sizes, for example. Even in less affluent countries, the fat ‘little Emperors’ of small families amongst the urban well-to-do are becoming legendary.

The extent to which the high prevalence of adult obesity has its origins in childhood obesity is widely debated. The question remains unanswered but it is clear that, along with increasing obesity in adults, there is increasing obesity in children at all ages. We are not short of theories for the development of obesity in children but we seem powerless to control the increase – leading to great concerns for future adult health.

Two of us met in 1988 because of a shared concern that too few of those speaking for obesity in childhood were clinically involved with children and their health.