BACKGROUND: Electronic health (e-Health) interventions may increase effectiveness and address limitations of conventional in-person childhood obesity treatment programs. This study evaluates the effectiveness of a 10-week e-Health (web-based) healthy lifestyle program for school-aged children with overweight/obesity. METHODS: In this randomised control trial (RCT), families with children aged 7 to 13 years with overweight/obesity (body mass index, BMI >= 85th percentile), living in Victoria, Australia, were recruited. Families were randomised to intervention or waitlist control and received the 10-week web-based program. The primary outcome was the change in children's BMI z-score over 10 weeks. Other outcomes included change in children's waist circumference, dietary intake, physical activity, and quality of life over 10 weeks. RESULTS: Of 148 children (125 families) recruited, 102 children (85 families) completed the RCT. A significant decrease in children's BMI z-scores was observed in the intervention compared to the control group over 10 weeks (mean difference 0.11; 95% CI 0.02 to 0.20). The web-based program was also effective in improving children's quality of life and lifestyle behaviour changes over 10 weeks. In the intervention group, there was a significant increase in children's quality of life scores (intervention versus control: median change (IQR) 11 (3 to 17) versus 1 (-3 to 7); p = 0.034), overall diet quality scores (6 (2 to 10) versus 2 (-3 to 5); p < 0.001), and daily physical activity levels (5.2 (-2.6 to 12.8) versus -0.2 (-8.2 to 4.5); p = 0.022) compared to the control group. CONCLUSIONS: A web-based healthy lifestyle program effectively improved short-term health-related outcomes in children with overweight/obesity. Further research is needed to identify determinants of program effectiveness, evaluate sustained effects, and equitably tailor childhood obesity e-Health interventions to diverse populations. TRIAL REGISTRATION: This study was registered with the Australian New Zealand Clinical Trial Registry (ACTRN12621001762842) on November 11, 2021, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=383053

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