This study evaluated physicians' childhood obesity screening and treatment practices. A 26-question survey was delivered to pediatric providers in-person or via mail, e-mail, or fax throughout Louisiana. Fifty-seven providers completed the survey, the majority in primary care clinics. Five providers met at least four of seven clinical guidelines, but no provider met all of the guidelines. Whereas 88% of providers screened for obesity, 7% met guidelines for referring patients with obesity to weight management services. Six providers offered interventions that included all recommended components (i.e. dietary, physical activity, and behavioral counseling). One intervention met intensity guidelines (i.e. >25 hours delivered over at least six months). Barriers to offering services included lack of reimbursement and poor compliance by families. Solutions to overcome treatment barriers should be identified to increase the provision of health care services for children with obesity.