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Objectives: To identify key barriers to effective engagement of primary health care (PHC) providers and families in promoting healthy weight among children aged 2–6 years, and to examine promising interventions to identify policy goals to overcome these barriers.

Methods: We conducted a literature review of published and unpublished articles from January 1990 to February 2006 using keywords relating to childhood obesity, risk factors, prevention, populations and primary care provider interventions, constraints and models. We identified barriers to engagement by PHC providers. Appraisal of “promise” was based on best available evidence and consideration of strengths and weaknesses of interventions in specific contexts and settings.

Results: Of 982 interventions aimed at the primary prevention of overweight and obesity among children, few related to 2–6‐year‐olds, with only 45 interventions meeting …