Technical Abstract: Most children, including lower socioeconomic status and ethnic minority children, play video games, use computers, and have cell phones, and growing numbers have smart phones and electronic tablets. They are comfortable with, even prefer, electronic media. Many expect to be entertained and have a low tolerance for didactic methods. Thus, health promotion with children needs to incorporate more interactive media. Interactive media for weight control and health promotion among children can be broadly classified into web-based educational/therapeutic programs, tailored motivational messaging systems, data monitoring and feedback systems, active video games, and diverse forms of interactive multimedia experiences involving games. This article describes the primary characteristics of these different technological methods; presents the strengths and weaknesses of each in meeting the needs of children of different ages; emphasizes that we are in the earliest stages of knowing how best to design these systems, including selecting the optimal requisite behavioral change theories; and identifies high-priority research issues. Gaming and technology offer many exciting, innovative opportunities for engaging children and promoting diet and physical activity changes that can contribute to obesity prevention and weight loss maintenance. Research needs to clarify optimal procedures for effectively promoting change with each change procedure.