Studies have found that higher maternal weight entering pregnancy increases risk for obesity and its cardiometabolic complications among offspring. Epidemiologic studies have found that higher maternal gestational weight gain is associated with higher weight and consequent risk for obesity, and elevated blood pressure among children. While these associations are partly mediated by shared genes and behaviors, the abundance of human evidence, supported by extensive data from experimental animal studies, suggests that intrauterine exposure to an obese intrauterine environment programs offspring obesity risk by influencing appetite, metabolism, and activity levels. Efforts to interrupt this cycle of obesity are important for public health and economical, as a successful intervention could benefit the child, the mother, her future pregnancies, and subsequent generations.