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The primary aim of this article is to review environmental determinates on eating and physical activity behaviors that lead to overweight status in the pediatric population.Selected articles on pediatric obesity and overweight and federal government publications addressing pediatric overweight, physical activity, and dietary habits.Obesity is one of the leading preventable causes of disease and death in the United States and is considered a major public health threat to Americans of all ages. An energy-dense diet coupled with low physical activity creates an environment conducive to obesity. Obesity warrants immediate attention and nurse practitioners (NPs) must implement proactive strategies to prevent the development of chronic disease in American children and adolescents. An initial key to successful prevention is identification of environmental supports and barriers that influence pediatric overweight.NPs must identify at-risk and overweight youth and translate current research findings into their practices. Designing and implementing age and family appropriate strategies that address positive and negative environmental influences is crucial to prevent or reduce the overweight epidemic.