"Combating obesity is the #1 health care problem for U.S. children," says Donald Lewis, chair of pediatrics at Children's Hospital of the King's Daughters. "A life expectancy shorter than their parents should stop people in their tracks," he says. "We have to disconnect love from feeding."

Children are significantly heavier today than they were even a decade ago. In the 1980s they re-normed the growth curve.

A child is considered obese when they have a BMI of

A child is considered obese when they score above the percentile on a weight chart for age.

Associated health problems: high blood pressure and hypertension, asthma, elevated cholesterol, joint pain, gastrointestinal problems, sleep apnea, insulin resistance, diabetes, some cancers, liver disease, depression.

By the numbers: More than 75 percent of Dominique Williams' Healthy You clinic patients have some form of anxiety or depression that most times has not been clinically diagnosed.

In the nation: It has taken a generation, but the nation's leadership has issued a call to action. As part of the White House Initiative, the AAP pledges to engage in a range of efforts toward 2 primary goals:

Body Mass Index (BMI) is calculated for every child at every well-child visit in accordance with AAP recommendations*, and that information is provided to parents about how to help their child achieve a healthy weight; and

Prescriptions for healthy active living (good nutrition and physical activity) are provided at every well-child visit, along with information for families about the impact of healthy eating habits and regular physical activity on overall health.^

* BMI measurement begins at the 24 month visit

In Virginia: Last year, the Virginia Tobacco Settlement Foundation took on obesity along with tobacco use in children.

"How to reverse obesity/ Baby obesity:

Change thinking: "They thought a big baby was a healthy baby." Harrington. Williams "People like a big chunky baby." Lewis. "We have to change the way people think. Stop them equating feeding with love.

Prenatal care:

A recent Yale University study of two groups of rats published in the National Academy of Sciences found that the brain is wired for fat before birth. However, the researchers are now looking at what role maternal obesity plays in affecting that determination. Lead researcher Tamas Horvath. The high-fat diet also led to inflammation in the brain which made it harder to lose weight.

It can't start soon enough, according to pediatricians at CHKD. Dominique Williams, medical director of CHKD's Healthy You clinic, a board-certified pediatrician with a degree in nutrition, believes weight control must start pre-conception. "The parental unit needs to determine that they're healthy. If at least one parent is obese it increases the risk for the child. The mother should gain the appropriate weight during pregnancy." John Harrington, director of general academic pediatrics at CHKD, and an associate professor at EVMS, released a groundbreaking study this year. In it he proposed that 2 years old was the tipping point for a lifelong tendency to obesity and its attendant problems. (The propensity is evident in half children at age 2, and 90 percent by age 5.) Now he's positing that as early as 3 months, babies can start on the path to lifelong obesity.

The problem can start with maternal weight. If a mother gains too much or develops gestational diabetes, then the children tend to be overweight. In Japan, he notes, the recommended gain for pregnant women is 17 or 18 pounds. Obese women can have small babies with high insulin resistance and truncal obesity; it affects the babies' weight and height from birth.

Breastfeeding: Babies should be breastfed. "It's an economical way to prevent obesity," says Williams. Parents should be counseled at the child's first well visits. They should learn about a hunger cry. Of the Healthy You clinic's patients, 40 percent will have persistent issues, 25 percent if it's caught when they're toddlers.