The high pediatric obesity prevalence requires continued examination of the causes of energy imbalance among youth and attention to childhood obesity treatment and prevention strategies. The literature regarding the causes of primary childhood obesity remains inconclusive. Most interventions for childhood obesity are behavioral, with evidence of long-term efficacy associated with intensive family-based behavioral weight control treatment. Recent advances in pharmacologic and surgical interventions for adult obesity have prompted their recent preliminary investigation among children. Behavioral interventions continue to be modified to attempt to improve efficacy and generalizability across the spectrum of children seeking treatment with overweight. School-based programs to reduce obesity incidence have also received recent attention and evaluation.