Obese infants do not always become obese children, and obese children do not always become obese adults. However, the occurrence of obesity increases with age among both males and females (Lohman, 1987), and there is a greater.

Chance that obesity beginning even in early childhood will continue through the life span (Epstein, Wing, Koeske, & Valoski, 1987).

Obesity presents several problems for the child. In addition to elevating the risk of obesity in adulthood, childhood obesity is the leading cause of pediatric hypertension, and is associated with Type II diabetes mellitus, increases the risk of coronary heart disease, increases stress on the weight-bearing joints, lowers self-esteem, and affects relationships with peers. Some authorities believe that social and psychological problems are the most important consequences of obesity in children.

Causes of Childhood Obesity
As with adult-onset obesity, childhood obesity has several causes centering around on an imbalance between energy in (calories obtained from food) and energy out (calories expended in the basal metabolic rate and physical activity). Childhood obesity most likely results from an interaction of nutritional, psychological, familial, and physiological factors.

The Family
The risk of children becoming obese is greatest for those who have two obese parents (Dietz, 1983). This may be because of powerful genetic factors or parental modeling of both eating and exercise behaviors, indirectly affecting the child's energy balance. One half of parents of elementary school children never exercise vigorously (Ross & Pate, 1987).

Low-energy Expenditure
The average American child spends several hours every day watching television; time which in previous years might have been devoted to physical activities. Obesity is greater among children and adolescents who frequently watch television (Dietz & Gortmaker, 1985), not only because little energy is expended while viewing but also because of concurrent consumption of high-calorie snacks. Only about one-third of elementary children have daily physical education, and less than one-fifth have extracurricular physical activity programs at their schools (Ross & Pate, 1987).

Heredity
Not all children who eat unhealthy foods, watch several hours of television every day, and are normally inactive develop obesity, the search continues for alternative causes. Heredity has recently been shown to influence fatness, regional fat distribution, and response to overfeeding (Bouchard et al., 1990).

In addition, infants born to overweight mothers have been found to be less active and to gain more weight by age three months when compared with infants of normal weight mothers, suggesting a possible inborn drive to conserve energy (Roberts, Savage, Coward, Chew, & Lucas, 1988).