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Barriers to Lose Weight from the Perspective of Children with Overweight/Obesity and Their Parents: A Sociocultural Approach

Introduction: There are not enough studies about the barriers to lose weight from the perspective of children and their parents. 

Methods: Children and adolescents diagnosed with overweight/obesity in the Department of Endocrinology and their parents were invited to participate in a series of focus group discussions (FGD). Twenty-nine children 10–16 years old and 22 parents participated in 7 focus groups; 2 mothers and 2 adolescents participated in depth interviews. All interviews were recorded, transcribed, and analyzed through grounded theory. 

Results: Parents went to the hospital only when their children presented any obesity complication; for them, overweight was not a health problem. Parents referred to lack of time to supervise about a healthy diet and exercise; besides, the same parents, relatives, friends, and the mass media encourage the consumption of junk food. Children accepted eating a lot, not doing exercise, skipping meals, and not understanding overweight consequences. Both, parents and children, demanded support to do the time recommended for exercise inside the schools. They also suggested getting information from schools and mass media (TV) about overweight consequences, exercise, and healthy food by health workers; they recommended prohibiting announcements about junk food and its sale. 

Conclusions: The barriers detected were lack of perception of being overweight, its identification as a disease and its consequences, lack of time to supervise a healthy lifestyle, and a big social influence to eat junk food.

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Alex’s Notes: Whether you are someone, or know someone, who has difficulties losing weight, an intimate question to ask is “why?” What are the barriers to weight loss? There are obviously many answers and many perspectives on this issue, but the fundamental question remains the same and the answers to it often elude those looking for them. Although the current study focuses on the parent-child relationship, the results really can – and I would believe they do – apply to a number of people.

The children involved in this study were 10-18 years old and overweight or obese as defined by being above the 85th and 95th BMI percentile, respectively, for that child’s age and gender. Importantly, these children were diagnosed by their pediatric physician as being overweight or obese and thus both them and the parents were aware that a weight problem existed. Twenty-nine children and 22 parents were split into four focus groups with a social psychologist who explored weight perception, causes of being overweight, limitations to lose weight, habits and beliefs, opinions about social support, suggestions to lose weight, and ways to get more information about the health problem.

Four principle themes emerged from discussion within the groups, which I summarized below.

Limitation to lose weight

Almost all parents did not perceive their child as being overweight or obese.

Parents felt guilty about leaving their children for work and compensated by buying them fast food.

Mothers have no time to supervise diet or exercise.

Cost of healthy food is too great.

Parents & children were unaware of the consequences of being overweight.

Parents believed being too thin was an illness

Eating and activity habits and beliefs

Not enough time to prepare breakfast, lunch, or dinner.

Insufficient sleep

Children and parents eat more junk food on weekends.

Parents would rather have their children inside watching TV then outside playing in fear of danger.

Children have a lack of time, places, and money to play outside.

Drinking water is more expensive than drinking soda or juice.

Children hear from some adults that eating vegetables “is for animals.” But they don’t believe it.

Parents believe thinness is an illness and that children should not restrict their eating, believing that what is overweight/obese is a sign of growth and good health.

Social support

Providing junk food is a sign of affection.

No school options for healthy food.

Physicians no nothing about a healthy diet.

Recommendations to lose weight

Children and parents suggest TV programs on healthy diets and exercise to lose weight because all people watch TV.

Parents believe that the school must educate about the consequences of being overweight/obese.

Children demanded to learn about healthy foods and their weight consequences, recommending that schools ban fast food and offer healthy options.

Parents understand “monkey see, monkey do” but say they don’t have time to set an example.

It has been suggested that more than 44% of children underestimate their body size, and about a third of physicians do as well. Moreover, parents are more concerned with their child being underweight. In the current investigation, the parents accepted that they themselves and their families equated thinness to disability and pointed to this belief as the basis for recommendations to eat a lot. Interestingly, despite the fact that the children listened to this idea, they did not agree and expressed wanting to lose weight. It could be speculated that those who didn’t want to lose weight simply did not want to cause conflict within the family and go against their parents beliefs.

Despite the above, it has been demonstrated that children became angry when they were restricted to eat certain foods or told to exercise. This is not surprising, as when people are imposed to change without the freedom to do so in their own manner, it usually leads to the opposite outcome. In the current study, all the parents and children demanded a clear explanation about being overweight/obese and its consequences and how to eat healthy and lose weight, suggesting that a viable way to approach the problem is to lay all the cards on the table and be clear and concise on the problems with being overweight and why underweight concerns are not as great.

Finally, remember that these parents and children were already aware of their weight problems. Thus, these barriers to weight loss must be viewed in the context of someone who knows a problem exists, but can’t seem to find motivation to fix it. Overall, the authors conclude that,

“intervention programs must consider the lack of perception of being overweight/obese, its identification as a disease, and its consequences; the lack of time of parents to supervise diet and exercise of their children; the great influence of relatives, friends, school, and mass media to eat junk food and the possibility to educate about it from schools and mass media (principally TV) by health personnel.”

This is a very fair conclusion.

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