Childhood obesity has become a national concern, health threat, and is increasing at an alarming rate. Obesity is associated with many comorbidities that last into adulthood. Insulin-resistant syndrome (IRS) is developing in growing numbers of obese children. Pediatric nurses play a unique and important role in identifying which children are at risk for obesity and IRS. This article gives current information on what tools to use, how to identify those children, and the interventions needed.