Childhood obesity is associated with serious physiological and psychological consequences including type 2 diabetes, higher rates of depression and low self-esteem. With the population of overweight and obese youth increasing, appropriate interventions are needed that speak to the issue of motivation to maintain adherence to healthy behavior changes. The current investigation was a randomized controlled trial examining the efficacy of Motivational Interviewing (MI) as an intervention for promoting self-efficacy and weight-loss in a sample of overweight and obese youth. Participants (N = 42) ages 10-18, were randomly assigned to a control (social skills training) or treatment (MI) group. Both groups received individual therapy (~30 minutes/month) in addition to usual care of diet/exercise counseling. Pre and post (at 6 months follow-up) variables included measures of self-efficacy and anthropometrics. Results indicated that while significant between-group differences were not found, individuals in the MI group attended more sessions. Overall, participants in both groups showed significant increases in self-efficacy and a trend of decreased BMI z-scores. Though health benefits from participation in individual therapy may have been accrued, specific benefits attributable to MI were limited. Findings from the current study suggest that more than one type of counseling intervention (i.e., MI and social skills training) may be beneficial when providing integrative treatment for obese youth.