Little is known about parental preferences on how providers should approach or manage weight-related concerns. A cross-sectional survey was conducted of 292 parents in a pediatric primary care faculty group practice. Of the 292 respondents, 90% were women, 45% had a child on Medicaid, and 53% had a body mass index of 25 or more. Only 12.1% of parents reported they had an overweight child. The term "gaining too much weight" was preferred 2:1 to "overweight" (51.1% versus 25.9%, P < .001). Most respondents (62.3%) thought the physician's office was the best place to manage an overweight child. Parents who reported they had an overweight child were more likely to prefer individual than group sessions compared with those without an overweight child (odds ratio, 2.1; 95% confidence interval, 1.2-3.7). Further research is needed to investigate the reasons underlying these preferences and how they positively or negatively impact program satisfaction, attrition rates, and behavior change outcomes.