The retail food environment and food-related ecosystem in the United States is not designed to help people achieve their best health. Insufficient access to, cost of, and inconvenience associated with many nutrient-dense foods (e.g., fruits and vegetables) and overabundance of highly palatable, energy-dense foods [e.g., ultra-processed food (UPF)] are key contributors to dismal statistics regarding diet, obesity, and related chronic disease in the United States. These resulting dietary patterns and persistent environmental exposures contribute to patterns of eating behavior that contribute to over-consumption and adverse relationships with food (e.g., emotional eating) that influence the risk of obesity. While prevention efforts are a key element of strategies designed to target these issues (e.g., community- and/or school-based obesity prevention programs), when intervening with children, the impacts of parents and families cannot be underestimated, and are equally important in predicting the long-term success of such strategies. In addition to ensuring consistent access to high-quality foods for families through ongoing policy change, behavioral support is key. This support must entail the use of empathetic, autonomy-supportive strategies [e.g., motivational interviewing (MI)] that have a strong empirical base to support modification of behaviors that are difficult to change, and result from complex exposures over the life-course, rather than deficiencies in knowledge. Integrating such behavioral support with efforts to augment access to nutrient-dense food is critical to assist families in navigating necessary changes, and these should occur alongside comprehensive change targeting food policy and systems, approaches which collectively provide a critical opportunity to support family change and enhance family resilience.