Recent increases in child obesity have sparked concerns about competitive foods--foods sold to students at school that are not part of federally reimbursable school meals. The nutritional value of these foods is largely unregulated, and students can often purchase these foods in addition to or instead of school meals. Nearly 9 out of 10 schools sold competitive foods to students in school year 2003-2004, and the availability of competitive foods sold in middle schools and through a la carte lines has increased over the last 5 years. Schools often sold these foods in or near the cafeteria and during lunch, and the competitive foods available ranged from nutritious items such as fruit and milk to less nutritious items such as soda and candy. High and middle schools were more likely to sell competitive foods than elementary schools. The six school districts visited all recently took steps to substitute healthy items for less nutritious competitive foods. In each district, committed individuals took actions to initiate and lead change while also involving those affected. However, districts faced several barriers to change, including opposition due to concerns about revenue losses. In recent years, federal, state, and local governments have increasingly focused on the role that competitive foods play in children's diets. The April 2004 report on competitive foods, revealed that increasing numbers of state legislatures are enacting and proposing legislation to restrict the availability of competitive foods in schools. In addition, school districts and schools themselves are taking steps to limit the availability of competitive foods. Appended are: (1) Scope and Methodology; and (2) GAO Contacts and Staff Acknowledgments. (Contains 8 tables and 10 figures.)