This study examined the relations between specific adherence variables and child outcomes among a sample of 60 families participating in a family-based pediatric obesity program. Adherence was measured using both objective and self-report methods. Family adherence to the treatment protocol significantly predicted child outcomes. However, parent self-report measures of adherence were better predictors of child outcome than objective measures. The importance of including parent self-report measures of adherence for behaviors outside of the treatment setting was demonstrated in this study. Pediatric obesity treatment should emphasize the importance of modifying parent behaviors as a means for improving child outcomes.