West Virginia is a state at the forefront of the obesity epidemic and one that is experiencing immense health and economic costs as a result. The childhood obesity research discussed in this article was conducted over the past 10 years through four projects that range from a school-based cardiovascular risk screening program to an evaluation of state legislation targeting childhood obesity via modifications in the school environment. In the course of these projects, evaluators collected body mass index (BMI) and other health indices on students; provided feedback to students and their parents; and assessed the obesity and health-related beliefs of West Virginians through individual and focus group interviews and questionnaires. The work has been accomplished by using an active-consent process, and BMI has typically been only one component of the comprehensive health data they collect and feedback they provide. Collaboration with state and local partners and regular dissemination of findings have been key elements of the approach taken. In this article, the authors discuss the research and policy implications of the findings and their approach.