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This qualitative study investigates health care practitioners’ approaches to early childhood obesity in Denmark and their view on their own ability to initiate processes of change in affected families, and it asks the overall question of whether perceived barriers become real through practitioners’ reluctance to intervene in families labelled as ´problematic’. The paper identifies three approaches in the practitioners’ narratives: the socially oriented, the individually oriented, and the mixed. The individually oriented approach was based on a logic resembling individualistic explanatory models of behaviour change, and was related to a positive perspective on their own ability to move families towards healthier habits by health care practitioners. The socially oriented approach borrowed elements from a sociological perspective, which seemed to lead to resigned pessimism in the face of the complexity of the problem of childhood overweight and a reluctance to address early childhood overweight in some families. In practitioners of all three types, widespread cultural essentialism was found. Non-western, ethnic minority background was seen as determining family habits and making preventive action especially difficult. Based on this, the current paper discusses whether individual actions and choices are being ascribed too much explanatory power, and the health system's biased perceptions too little.