Many family-based treatments for pediatric obesity teach specific parenting practices related to weight management. Although youth in these programs show increases in positive health behaviors and reductions in the extent to which they are overweight, most remain overweight after treatment. A recent trend is to create tailored programs for subgroups of families. We examine the possibility of tailoring based on family context, highlighting 3 aspects of family context that have been studied in relation to pediatric obesity: parenting style, family stress, and family emotional climate. We argue that family context may moderate treatment outcomes by altering the effectiveness of health-related parenting practices and discuss the implications of this argument for designing and evaluating tailored programs.