Childhood obesity is a signicant public healthproblem. The causes of obesity are complex andextend across biological and social ecologies.This article focuses on how proximal regula-tory processes connect biological risk for obesityand family systems. Response to satiety, distressduring feeding, organization of family routines,and exposure to food marketing are provided asexamples of the complexity of risk for obesity.The article concludes with recommendations forpractice and policy to prevent childhood obesityand to empower families to take an active role intheir community.