Purpose of Review <p>The goal of this narrative review is to summarize the evidence regarding the impact of preconception weight loss and preconception weight loss interventions on child obesity, describe ongoing challenges surrounding preconception weight loss intervention research, and discuss future directions.</p> Recent Findings <p>Data are sparse regarding the impact of preconception weight loss and preconception interventions on offspring outcomes beyond birth. There is insufficient evidence to determine the impact of preconception weight loss interventions on childhood obesity.</p> Summary <p>Future research should include long-term observational studies and multi-center randomized trials during the preconception period among participants from diverse geographic and cultural backgrounds. Studies should be of sufficient sample size and duration to fully assess the impact of preconception interventions on childhood obesity and other important measures of child health. Ongoing challenges include those related to identification and recruitment of people prior to pregnancy, determining the optimal lifestyle intervention design to optimize impact on child health, and long duration of required follow up to examine child outcomes.</p>