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As more and more children become obese more and more articles describe the ill effects and precursors of obesity. The take home messages from a spate of articles in a single issue of the Journal of Pediatrics are: 1) severe obesity may cause renal disease; 2) overweight children are often still obese, and more likely than others to have cardiovascular risk factors, as young adults; 3) C reactive protein concentrations are raised in obese children; 4) American children are eating more snacks than they used to; and 5) gastric bypass surgery may be indicated in very severe obesity. Over a period of 12 years a diagnosis of obesity related renal disease was made for seven 10–16 year old African American children at two large hospitals (Journal of Pediatrics2001;138:481–5). They had proteinuria, mild hypertension, moderate hypercholesterolaemia, and focal segmental glomerulosclerosis. Weight loss was followed by much reduced proteinuria in one patient. In Minnesota (ibid: 469–73) 31 subjects were studied at age 13 years and again at age 22 years. Body mass index (BMI) at age 13 correlated positively with BMI, serum cholesterol, and insulin resistance at age 22. The US Third National Health and Nutrition Examination Survey of 1988–94 included data about over 5000 children (ibid: 486–92). Those with a high BMI (95th centile or greater) had a fivefold increase in odds for a raised C reactive protein concentration. Adipocytes produce cytokines which induce the production of acute phase reactants. Data from three national surveys between 1977 and 1996 show an increase in the number of snacks taken by American children outside usual meal times (ibid: 493–8). In New Jersey (ibid: 499–504) ten 15–17 year olds had gastric bypass surgery for severe obesity (BMI 41–70 kg/m2). Their mean postoperative weight loss was 54 kg and their associated morbidity (hypertension, breathing problems) resolved. Late postoperative complications necessitated more surgery in four patients.