Attitudes and biases toward body size perceived as fat and body size perceived as thin are present in young children (Cramer and Steinwert in "J Appl Dev Psychol" 19(3):429-451, 1998; Worobey and Worobey in "Body Image" 11:171-174, 2014). However, the information children have regarding body size and ways to modify body size might not be accurate, which could lead to negative health outcomes. To collect information for developing strategies to prevent such health outcomes, this study explored children's perceptions towards body size, factors they believed contribute to body size differences, and strategies they indicated as necessary to make changes in body size. Forty-eight children from 1st grade and 3rd grade were interviewed. The majority of children were aware that the quality and quantity of food influences body size. They expressed similar strategies to change body size; however, some of their strategies were extremely unhealthy. Children in this group prefer an average body size rather than the thinnest size body from the selections presented. Information obtained from the study demonstrated the importance of guiding children to establish appropriate eating and healthy habits that might ultimately prevent extreme behaviors and health problems. It is crucial to help all children realize the importance of maintaining a healthy body rather than an overly thin body.