Background. Since most people are aware of their clothing size (CS), this prospective study explored the potential utility of CS as a proxy for body size and as a predictor of incident obesity-related health conditions in children. Methods. This was a prospective, cross-sectional study of 725 children aged 6–18 yr. We collected clinical, anthropometric, and sartorial data on all study subjects. Parents reported their children’s usual CS. This was compared with US clothing chart for children. Based on this we determined whether a child’s CS was appropriate or large for age. Results. The prevalence of overweight/obese was 31.4%. Among the study subjects, 36% usually wore large CS. Children who wore large CS were more likely to be overweight/obese compared to those in the normal CS group (OR？=？5.6; 95% CI？=？4.0–8.0, ). Similarly, large CS was associated with higher rates of incident asthma ( ), obstructive sleep apnea ( ), habitual snoring ( ), and elevated preoperative blood pressure ( ). Conclusion. CS in children is associated with higher indices of adiposity and increased rates of obesity-related comorbidities. 1. Introduction Obesity has reached epidemic proportions in American adults and children and in most parts of the developed world [1, 2]. Childhood obesity has indeed become one of the foremost issues in contemporary biomedical research particularly because of its importance in predicting adult overweight and obesity as well as its association with various cardiovascular risk factors [2]. The most common descriptor of obesity (used for health promotion information and risk stratification) is the body mass index (BMI), defined as an individual’s weight in kilograms divided by the square of their height in meters (BMI =？？kg/m2) [3, 4]. It is however becoming increasingly clear from clinical and epidemiologic studies that BMI may not be an accurate proxy for obesity-associated risks [5–7]. This is because BMI does not specify fat distribution and compared to other indices of adiposity, it correlates poorly with visceral (central) obesity, which tends to be more pathogenic given its close association with cardiovascular and metabolic risks [8–10]. Furthermore, central adiposity is associated with severe obstructive sleep apnea (OSA) in adults [11] and central apnea with severe nocturnal oxygenation desaturation in children [12, 13]. Due to the many limitations of BMI as a risk stratifier, other indices of adiposity are being explored. Waist circumference (WC) measurement is the most commonly used measure of central adiposity and has become the
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