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Objective: A previous report from our group identified directionally unfavorable dietary and lifestyle behavior trends in longitudinally monitored children and adolescents with obesity early in the COVID‐19 pandemic lockdown. The current study aimed at extending these previous observations in youths with obesity on the dietary and lifestyle behavioral consequences of the extended COVID‐19 lockdown in Verona, Italy. Methods: The sample included 32 children and adolescents with obesity participating in the longitudinal OBELIX study. Diet and lifestyle information were collected pre‐pandemic, 3 weeks into the national lockdown, and 9 months later when home confinement continued to be mandatory. Changes in outcomes over the study time points were evaluated for significance using repeated‐measures ANOVA and post‐hoc pairwise t‐tests with Bonferroni corrections. Results: As previously reported, meals/day, fried potato intake, and red meat ingestion increased significantly (p < 0.001) during the initial lockdown. Sleep time and screen time increased and sports participation decreased significantly (p < 0.001) during the initial lockdown. These changes in health behaviors remained significantly different from baseline at the second lockdown assessment, with the exception sleep time returned to baseline levels. Conclusions: Unfavorable diet and lifestyle behavioral changes in response to the initial COVID‐19 lockdown in children and adolescents with obesity have largely been sustained over the course of the pandemic. There is an urgent need to intervene on these behaviors to prevent further deleterious effects on long‐term child health; access to weight management care is critically important for these children. In addition to intervening on these behaviors, our findings should help to inform ongoing lockdown policies. [ABSTRACT FROM AUTHOR]