The worldwide epidemic of type 2 diabetes has been paralleled by a marked increase in the prevalence of obesity, particularly in younger people. This will contribute significantly to the future burden of cardiovascular disease. Complex environmental and genetic factors contribute to obesity and related metabolic disorders. These disorders are now manifesting in younger age groups, including children. Recent studies have described the clinical and metabolic characteristics of these children. A solution to the obesity crisis will need to be co-ordinated, multi-faceted and well resource.