Child and adolescent obesity is increasing at a rapid pace. A significant contributing factor relates to the overall decline in physical activity for both children and adults. It will take efforts by many to reverse this trend. Primary care and sports medicine providers are poised optimally to counsel patients on the benefits of regular physical activity. However, only a minority of patients are counseled regarding physical activity at any given office visit. To improve upon this, providers need to understand current recommendations regarding physical activity, have available clinical tools that help in the diagnosis of physical inactivity, and develop office systems to ensure consistency in addressing physical activity at every office visit.