Obesity in the U.S. is a major health issue that has galvanized policy makers and public health advocates nationwide. A recent Institute of Medicine (IOM) report reveals that over one-third of adults are now obese, with minorities often suffering even higher obesity prevalence. The Division of Nutrition, Physical Activity, and Obesity (DNPAO) at the U.S. Centers for Disease Control and Prevention (CDC) has partnered with health information technology (HIT) experts, state and local public health agencies, and the Public Health Informatics Institute (PHII) to develop the Healthy Weight Surveillance initiative. This project seeks to utilize electronic health record (EHR) data captured during patients’ clinical encounters for more detailed descriptions of obesity prevalence to better inform interventions. The purpose of this report is to provide guidance to public health agencies seeking to implement obesity surveillance and introduce new electronic health record (EHR) interoperability standards designed to support this activity.