text: Weight Related Behaviors of Children with Obesity during the COVID 19 Pandemic b i Background i b During the coronavirus disease 2019 COVID 19 pandemic children and families have had to adapt their daily lives The purpose of this study was to describe changes in the weight related behaviors of children with obesity after the onset of the COVID 19 pandemic b i Methods i b Semistructured interviews i n i 51 were conducted from April to June 2020 with parents of children with obesity Families were participants in a randomized trial testing a clinic community pediatric obesity treatment model During interviews families described their experience during the COVID 19 pandemic with a particular emphasis on childrens diet physical activity sleep and screen time behaviors Rapid qualitative analysis methods were used to identify themes around changes in childrens weight related behaviors b i Results i b The mean child age was 9 7 2 8 years and the majority of children were Black 46 or Hispanic 39 and from low income families 62 Most parent participants were mothers 88 There were differences in the perceived physical activity level of children with some parents attributing increases in activity or maintenance of activity level to increased outdoor time whereas others reported a decline due to lack of outdoor time school and structured activities Key dietary changes included increased snacking and more meals prepared and consumed at home There was a shift in sleep schedules with children going to bed and waking up later and an increase in leisure based screen time Parents played a role in promoting activity and managing childrens screen time b i Conclusions i b The COVID 19 pandemic has created unique lifestyle challenges and opportunities for lifestyle modification Clinical Trials ID NCT03339440 