Matthew J. Landry, John James Parker
PURPOSE OF REVIEW: This narrative review aims to synthesize recent evidence demonstrating that paternal influences can significantly affect child obesity risk through biological, psychosocial, and behavioral pathways and to highlight implications for clinical practice, public health, and research. RECENT FINDINGS: Paternal obesity influences offspring metabolic health through three primary mechanisms. Biologically, paternal obesity alters sperm epigenetic signatures, which are transmissible to offspring and modifiable through preconception lifestyle interventions. Behaviorally, fathers' dietary quality, physical activity, feeding practices, and parenting styles directly shape children's eating patterns and activity levels, with the transition to fatherhood representing a critical period when paternal weight gain and lifestyle changes commonly occur. Socioecologically, social determinants of health including food insecurity, neighborhood characteristics, and paternal mental health create shared family-level exposures that simultaneously influence paternal physiology, parenting behaviors, and childhood adversity, compounding obesity risk across generations. Fathers play a pivotal role in shaping child obesity risk from preconception through childhood. Advancing obesity prevention requires expanding preconception counseling to include fathers, implementing father-inclusive perinatal education and obesity prevention programs, adopting workplace policies that support paternal engagement, and prioritizing research that elucidates paternal contributions to intergenerational obesity transmission.