PurposeWe sought to explore perceived barriers to engaging in weight-related health behavior change among parent child dyads.DesignThis is a secondary analysis of data from a cluster-randomized controlled trial investigating the effectiveness of Fitline telephonic coaching vs Fitline workbook at improving weight-related health behaviors and body mass index for children 8-12 years old with overweight and obesity.SettingThe trial which the present data comes from was conducted within 20 pediatric primary care practices in Central Massachusetts.SampleData from 499 parent-child dyads were included.MeasuresBarriers to weight-related health behavior changes were assessed via 10 survey items answered by parents and the enrolled child at baseline, 6- and 12-month.AnalysisWe used frequencies to describe the distribution of parent and child reported behavior-change barriers as well as McNemar's and Bowker's tests to compare distributions of behavior-change barriers at baseline and change in report of behavior-change barriers at 6-month.ResultsWe found that barriers to weight-related health behavior change varied within parent child dyads with up to 30% of dyads disagreeing on behavior-change barrier perception at baseline. Additionally, up to 37% of dyads were not aligned on reported change in barriers to health behavior change at 6-month.ConclusionOur findings support the potential benefit of integrating behavior-change barrier assessment from both the parent and child perspectives into intervention delivery when developing and tailoring family-centered interventions.