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Food insecurity and overweight/obesity coexist among youth; however, evidence for their association has been mixed. Our objectives were to assess the association between (1) level of food security and weight classification and (2) food insecurity and perceived nutritional and exercise barriers in an urban youth population. Patients aged 15 to 25 years completed a US Department of Agriculture Food Security Survey. Chi-square, Kruskal-Wallis tests, and logistic regression models controlling for age and gender assessed the association between food security level, weight classification, and perceived barriers. Among 376 patients, 122 (32%) were food insecure and 221 (59%) were overweight/obese. There were no significant associations between food security level and weight classification. In adjusted analyses, participants with very low food insecurity reported significantly greater odds of 3 nutritional barriers compared to participants with high food security. Food-insecure youth were more likely to report nutritional barriers, which may lead to overweight/obesity over time.