Obesity is a determinant of cardiovascular risk factors in childhood, adolescence, and adulthood. Since the inception of the Bogalusa Heart Study, various anthropometric measures of body size and mass have been obtained. Attention is given to identifying the distribution for various obesity measures, secular trends in obesity, clustering of obesity with other risk factors, and obesity during childhood as a predictor of risk factors during young adulthood. Race, gender, and age differences offer clues to etiology of future clinical disease and cardiovascular risk. Innovative programs are needed to alter the secular trend over the past 20 years toward increased obesity. General wellness must include a reduction in obesity.