Obesity in childhood is perhaps the most major clinical and public health problem in the United States and most developed countries and is rapidly becoming so in developing countries. The National Health and Nutrition Examination Survey (NHANES) is a federally funded periodic survey of a random sample of the U.S. population. In NHANES data over the past several decades, there is a 3-fold increase in the prevalence of obesity in childhood (1–4). These data are alarming but, perhaps not surprising.

The landmark Framingham Heart Study, which enrolled and followed over 5000 residents of a single community in Massachusetts for over 40 years, has demonstrated that in middle age the average American gains about seven pounds per decade of life. Thus, for these and other cogent reasons, it appears that, at present, the adult population of the U.S. is the fattest society in the world and likely to be the fattest in the history of the world (5). Further, there are even more alarming trends in obesity in childhood in developing countries (6,7). Thus, the epidemic of obesity in childhood in the United States and most developed countries is now becoming a pandemic.

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