Childhood obesity is one of the most pressing public health and medical problems in the United States. In the US, prevalence rates of childhood overweight and obesity have tripled in the past 30 years and the health implications and related medical costs of the disease are already evident. For the first time ever, weight-related Type 2 diabetes is being diagnosed in youth. Experts suggest that even if obesity prevalence remains static in the US, the lifetime risk of Type 2 diabetes for children born in 2000 is estimated at 30% for boys and 40% for girls (Narayan et al. J Am Med Assoc 290(14): 1884–1890, 2003). Annual hospital-related costs associated with treating obese children increased from 35 million dollars in 1979 to more than 127 million dollars in 1997–1999, based on 2001 dollars (Wang and Dietz Pediatrics 109(5): E81–E86, 2002). In addition to financial costs related to treating obesity, there are myriad social and personal costs of being an obese child and adult. This alarming rise in obesity rates among youth has been followed by initiatives by both the medical and public health communities to find appropriate and effective treatments as well as ways to prevent obesity. The following offers an overview of current trends and initiatives from both sectors and concludes with some thoughts on what the future may hold.