Few studies have examined the long-term effects of childhood obesity on adult disease. Nonetheless, obesity present in childhood or adolescence seems to increase the likelihood of adult morbidity and mortality. In men who were obese during adolescence, all-cause mortality and mortality from cardiovascular disease and colon cancer were increased. In both men and women obese during adolescence, rates of cardiovascular disease and diabetes were increased. Among women but not men obese during adolescence, obesity has a variety of adverse psychosocial consequences. These include completion of fewer years of education, higher rates of poverty, and lower rates of marriage and household income. These effects seem related both to the persistence of obesity and to the effects of childhood or adolescent obesity on the quantity and location of body fat deposition. Approximately 50% of obese adolescents with a body mass index at or above the 95th percentile become obese adults. Furthermore, the risk factors for adult disease that are associated with obesity in children and adolescents persist into adulthood or increase in prevalence if weight gain occurs. Although both total body fat and regional fat deposition could account for the association of childhood or adolescent obesity with adult disease, no studies to date have examined cardiovascular risk factors and related them to visceral fat, controlled for total body fat.