Technical Abstract: The study objectives were to assess the association between weight dissatisfaction, weight status, and weight loss in Mexican-American children participating in a weight management program. Participants included 265 Mexican American children recruited for a school-based weight management program. All children completed baseline assessments, and changes in standardized body mass index (zBMI) were monitored in at-risk for overweight and overweight children (i.e., > 85th BMI percentile) who had been randomized to receive the weight loss intervention (n = 101). Participants classified as at-risk for overweight or overweight reported greater weight dissatisfaction than normal weight children. Lower weight dissatisfaction at baseline was associated with greater changes in zBMI at 6 months. Weight dissatisfaction did not change across the course of treatment. Mexican-American children whose weight status is greater than normal have greater weight dissatisfaction. Children with greater weight dissatisfaction are less likely to lose weight in a weight management program, and weight dissatisfaction remains stable over the course of treatment.