Obesity in children is a growing public health problem that is associated with serious comorbidities including diabetes, cardiovascular disease, musculoskeletal and mental health disorders, and cancer. The etiology of obesity in children is complex and encompasses dietary and behavioral practices, genetic background, the prenatal milieu, and the social and community environment. Treatment is founded on intensive health behavior and lifestyle modification focusing on nutrition counseling and increasing physical activity. Obesity care should be delivered by a multidisciplinary team in a sustained and longitudinal manner. This should include behavioral health assessment and an evaluation of sleep quality. Pharmacotherapy and bariatric surgery are safe and effective options for cases that are severe and refractory to behavioral interventions.