Obesity has become an epidemic in our pediatric population. More recently, an increased population of obese children are presenting for AT with upper airway obstruction with or without tonsillar hypertrophy, which is similar to the adult etiology of OSA. Obesity is a multisystem disease, causing fatty liver and cardiac disease, defects in glucose metabolism, insulin resistance, leptin resistance, and creates a state of chronic inflammation. Markers for inflammation, including TNF-α, CRP, leptin, IL-6 and IL-10, are abnormal in obese patients and have also been linked to more severe OSA disease in children even after controlling for BMI.