An extensive body of research demonstrates a higher prevalence of obesity among children with developmental delays (DD) versus children without delays. This analysis examined the effectiveness of a randomized controlled trial to promote healthy weight in a subsample of preschool-age children with DD (n = 71) on the adoption of quality nutrition and increased physical activity habits versus controls. Child care centers (N = 28) randomized to the intervention group received a multilevel (parent, teacher, child) role modeling program and curriculum on obesity prevention. Results showed that children in the intervention group slightly decreased their junk food consumption while the control group increased their junk food consumption. In addition, among preschool-age children with DD, change in parent fruit and vegetable consumption significantly influenced change in their child's consumption. Conversely, the greater the consumption of junk food by parents, the greater consumption by their children. Results imply that preschool-age children with DD may benefit from child care center-based healthy weight programs.