Given the scarcity of effective obesity prevention programs, there is a pressing need for innovative and scalable models that begin early in life and break risk cycles. Promising evidence exists that multisystemic preschool programs can promote healthy body mass and positive behaviors, but to our knowledge, no existing or large-scale programs have assessed long-term links between such programs and health outcomes in midlife. We assessed the association of participation in an evidence-based, multicomponent Child-Parent Center (CPC) preschool program in Chicago, Illinois, with body mass and obesity at age 37 years for a sample of predominately Black individuals who grew up in poverty. (author abstract)