The need for effective treatments for pediatric overweight is well known. To evaluate the applicability of an evidence-based treatment in an applied clinic setting that includes children with severe obesity and comorbid medical or psychiatric conditions. Forty-eight overweight children and their families were provided an evidence-based intervention at a for-profit clinic. Unlike typical lab-based samples, participants were self-selected and included children who were very overweight and/or had comorbid conditions. Change in standardized BMI was assessed. Overall, participants demonstrated a significant reduction in standardized BMI, t (40)=6.6, p<.001. Further analyses indicated that participants who were severely obese and children with a comorbidity significantly reduced their zBMI (t (11)=4.0, p<.01; t (14)=3.9, p<.01, respectively). Children who were severely obese reduced their BMI percentile by .2 (SD=.2) and those with a comorbidity reduced their BMI percentile by .6 (SD=.9). Nonsignificant interaction effects indicated comparable weight reductions in severely obese and overweight/obese participants, F (1,39) = 1.49, ns. Also, those with comorbidities and those without comorbidities experienced similar weight reductions, F (1,39)=.7, ns. This study provides promising evidence for the applicability of an evidence-based treatment for weight management in clinical practice.