Childhood obesity is a prevalent health condition, the effects of which extend to mental health, social relationships, educational performance, and long-term physical health conditions. The present study focused on an optimized student support intervention that functions in predominantly high-poverty urban locations, which recognizes students as possessing unique constellations of protective and risk factors. Participants included 5,573 K-5 students that support staff identified as being overweight through a holistic, collaborative assessment process, and evaluated how these students differed from peers not perceived as overweight. Findings indicated statistically significant differences across the groups, in terms of demographic characteristics, strengths and risks recognized (in academic, social-emotional/behavioral, family, and health/medical domains), school-related academic and thriving performance scores, and the moderating effects of specific psychosocial and familial strengths and risks on those educational areas. This study underscores the importance of considering both strengths- and risks-based assessment and intervention approaches -- as well as the utility of initial identification of students -- particularly in low-income, underserved environments.