Childhood obesity is a significant public health concern, with about 17% of children in the United States reported as obese (Centers for Disease Control and Prevention [CDC], 2012a). Family Mealtime Coaching (FMC) is a live coaching intervention using positive psychology interventions and modeling to improve mealtime parenting, child behavior and weight status, and parent–child communication. The purpose of this study was to examine how parent coaching affects feeding practices and pediatric obesity in 2 to 10 year olds. We used a pre-/postexperimental design comparing treatment assessments of children and their caregivers participating in FMC. Caregivers (N = 51) consented to participate in the study. Only those participants with at least 2 measurements of height and weight from which BMI could be calculated (N = 43) were included. The children averaged 6.96 years of age (SD = 2.7), ranging between 2 and 11 years of age, and 58% were female. The large majority were Latino (84%). Children’s baseline body mass index (BMI) averaged at the 97.3 percentile (SD = 3.4), and waist circumference averaged 78.02 cm. Results of analyses showed that children entering treatment within the upper limits of BMI percentile (i.e., 97th percentile or higher) were more likely to complete treatment and showed a significant reduction in BMI z score. The intervention also yielded significant increases in family style serving, intuitive eating, and mealtime communication; reduced maladaptive feeding comments among parents; and decreased problematic mealtime behaviors in the children. These findings suggest a promising empirical basis for using coaching to reshape feeding-related parent–child interactions.