Respiratory medicine has developed as a specialty in the wake of a number of public health milestones. The origins of many of the learned societies associated with respiratory medicine can be traced back to the epidemic of tuberculosis (TB) in the early 19th century.1 Effective public health and effective treatment regimes reduced the prevalence and mortality of TB. The seminal work linking the role of tobacco smoking and its detrimental effects on the lung2 was the second key finding which challenged our specialty. Public health measures and the development of new treatments are reducing the prevalence of smoking-related lung disease, although there is still much work to be done. Obesity has emerged in the opening years of this century as a major challenge to public health. The impact of obesity on the prevalence and mortality of many diseases is well documented, although there has been little attention paid to its impact on respiratory disease.

Obesity rates are rising at an alarming rate in developed and developing countries, in both sexes, in children and adults. The obesity epidemic in children is particularly concerning as …