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This study replicates and extends those findings in a larger dataset of families provided with Family\u2010Based Behavioural Treatment (FBT), examining whether dyad sex composition predicts change in zBMI and clinically meaningful weight outcomes at two\u2010year follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Mega\u2010analysis of individual participant data pooled from 9 randomised FBT trials conducted between 1981 and 2013, with weight outcomes assessed at 6, 12 and 24\u2009months. Clinically meaningful change was defined as \u2265\u20090.25 reduction in child zBMI and \u2265\u20095% parent weight loss.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Children, but not parents, in opposite\u2010sex dyads showed larger reductions in zBMI and greater odds of achieving clinically meaningful change across 2\u2009years. When examining the four dyad combinations separately, daughters in mother\u2010daughter dyads had the lowest odds of achieving clinically meaningful reductions, whereas daughters in father\u2010daughter dyads had the highest.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Parent\u2013child sex composition meaningfully influences children's long\u2010term response to FBT. Opposite\u2010sex dyads, particularly father\u2010daughter pairs, show more sustained benefits. These findings suggest that dyad composition should be considered when administering FBT and may help inform strategies to enhance treatment effectiveness for families.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ijpo.70130","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T04:22:26Z","timestamp":1783570946000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Parent\u2013Child Sex Composition Impacts Long\u2010Term Outcomes in Family\u2010Based Behavioural Treatment"],"prefix":"10.1111","volume":"21","author":[{"given":"Nicholas V.","family":"Neuwald","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences University at Buffalo  Buffalo New York USA"},{"name":"Center for Ingestive Behavior Research University at Buffalo  Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer L.","family":"Temple","sequence":"additional","affiliation":[{"name":"Center for Ingestive Behavior Research University at Buffalo  Buffalo New York USA"},{"name":"Department of Exercise and Nutrition Sciences University at Buffalo  Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Owen","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences University at Buffalo  Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1167-8848","authenticated-orcid":false,"given":"Leonard H.","family":"Epstein","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences University at Buffalo  Buffalo New York USA"},{"name":"Center for Ingestive Behavior Research University at Buffalo  Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.2009.28838"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.3345\/cep.2020.01620"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2024.5904"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.65919"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/5.1.25"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1037\/0278\u20106133.13.5.373"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1990.03450190051027"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ijo.0803256"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022\u20103514.47.6.1292"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10508\u2010018\u20101185\u20108"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2017.01.053"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2005.09.014"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.154.3.220"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022\u2010006X.68.4.717"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1037\/0278\u20106133.23.4.371"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/0306\u20104603(94)90038\u20108"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1207\/s15324796abm3003_4"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2007.61"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.298.14.1661"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022\u2010006x.49.5.674"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0005\u20107894(85)80002\u20102"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/cdn\/nzac120"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2024.5552"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacadv.2023.100570"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc10-2415"},{"issue":"9","key":"e_1_2_13_27_1","first-page":"644","article-title":"Statistical Considerations Regarding the Use of Ratios to Adjust Data","volume":"19","author":"Allison D. 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