A growing interest in psychological approaches to the treatment of childhood obesity has led to an “increased demand for insights into the psychological drives related to the development of obesity” and to the motivation in families with obese children (pg 183). Reports suggest that childhood obesity affects both the physical and the psychological health of the child, and the family is the main cause. There is very little research done on how to prevent childhood obesity.
Children undergoing treatment for obesity are dependent on both the family’s practical (socio-economical and lifestyle) and psychological (emotions and attitude) support. Thus, the purpose of this research was to “elucidate aspects of the family’s interactions and its understanding of who has a weight problem, of whom the family feels ought to change their health-related behavior (diet and exercise)” (pg. 188)
From November 2001 to November 2005, 100 families with obese children participated in the treatment project. The families were to include a 10 to 12-year old child whose weight was more than 40% above the weight-to-height ratio for children, and the family was willing to participate for one and a half years in treatment. Children were referred from school nurses, teachers or practitioners. Each family participated in a one-hour introductory interview, with only 53 of the interviews actually being completed.
There were three analyses that were comprised for the research: qualitative (family narratives), one for the families’ socio-demographic condition, and the third was the “ways in which the various narratives are represented in families from different socio-demographic backgrounds” (pg. 192). During the interview, participants responded to questions: “What does your family think are the causes to the child being overweight? Why do you (the child) want to lose weight (What is the motivation)?
Who is going to change anything concerning the eating habits in the family? What is the education of the mother/father?” (pg. 199) Finally an analysis of the relationship between the described narratives and the three educational categories was carried out, based on their percentile distribution in the sample.
In the first part of the analysis attention was directed to whether or not a family mentioned causal factors that may have influenced the child’s weight development (internally). Factors claimed by a family as influencing the development of excess weight that are clearly causal explanations were diet, exercise, and psychology (comfort eating, boredom, etc.).
“Almost all families (91%) stated that they had played a part in the development of their children’s obesity. Many of the parents (59% of the mothers and 22% of the fathers) had experience in trying to lose weight by dieting” (pg 201). The dietary factors specified by families as having played a part in the development of the child’s obesity was overeating unhealthy food. The second part was the external influences: The family claimed to have had no influence on the development of their child’s obesity.
Narratives belonging to this area of research fall into three categories: genetics, previous illness, and incomprehensible (the family had no clue as to why their child was obese.). All families had a short-term perspective on motivation for wanting to change their child’s weight development. Most of the families who also had a long-term perspective on motivation belonged to the two groups with the highest educational level. ‘More than three-quarters of the families (78%) believed their child’s overweight to be a family problem and that the whole family must participate in lifestyle modification” (pg 204). Half of the families (54%) felt that the child must assume responsibility of exercising.
It is suggest that more studies be conducted, mainly due to the fact that most of the families that were studied had relatively short educations. Contrary to expectations, there was no association between the parents believing that they had no influence on their child’s weight development and their feeling that it was the child alone who must act and change its behavior.