lead to weight gain. Polyuria, polydipsia and unexplained weight loss may suggest onset of diabetes mellitus. Scanty and Delayed or missed periods in girls with or without hirsutism may suggest the presence of polycystic ovarian disease (PCOD). Enquire about excessive daytime sleepiness, snoring and morning headaches for obstructive sleep apnea and knee or hip pain for Slipped capital femoral epiphyses. History of dietary practices, TV/screen viewing duration and physical activity may give some insight into the cause of weight gain. Majority of parents of obese children feel that their child’s weight gain is due to pathology and are oblivious to their life-style. A detailed dietary history with calculation of caloric intake would help convince them about the need for life style changes. 2) Anthropometry: Obtain a weight, height, calculate BMI and measure waist circumference (WC) if possible. Plot these measurements on respective charts for age and gender for the Indian population. BMI chart will classify the child as over-weight/obese and demonstrate the duration and rapidity of weight gain. Reduced height velocity suggests an endocrine problem whereas in exogenous obesity linear growth is normal. Waist Circumference (WC) is a good indicator of central adiposity and is a better predictor of metabolic syndrome (24,25), cardiovascular disease risk factors (26) and insulin resistance in children than BMI. A cut-off of 70th WC percentile is suggested to screen children for risk of MS in our popul>