Experiences of Families with Children Attending a Clinic-Based Weight Management Program

Abstract Interventions for children with obesity show modest improvements in body mass index (BMI) and long-term outcomes. Data are limited describing the experiences of families of children with obesity in clinic-based treatment. This scoping review seeks to answer the question: What is known about existing studies in clinic-based child obesity treatment as reported by families and children? Families report a lack of tailored interventions for individual needs and resources. Barriers and facilitators to treatment recommendations encompass 1) structural; 2) financial; 3) patient and family issues; and 4) personal behaviors, motivation, and expectations. Findings show a limitation in the application of uniform BMI-related measures identifying children with severe obesity and describe non-maternal experiences. Future research should identify variables which impact outcomes, include qualitative studies, and focus on children with severe obesity and fathers’/siblings’ perspectives. Researchers and healthcare providers should use the BMIp95 to accurately track children with severe obesity and evaluate interventions. Severe obesity, defined as a body mass index (BMI) >120th percent of the 95th BMI percentile for age and sex, is the fastest growing subcategory of obesity among children and adolescents. This qualitative descriptive study aimed to 1) document the experiences of parents and children with severe obesity who attend a clinic-based obesity treatment program, 2) explore how parents and children manage the treatment of severe obesity on a day-to-day basis, and 3) evaluate the applicability of the family management styles framework (FMSF) to families and children with severe obesity. With purposeful sampling, we recruited 15 families (14 children age 12-17, 17 parents) from a weight management clinic. One-time in-home face to face interviews were conducted with parents and children. Both parents and children described day-to-day management as a challenge impacting parent-child and sibling relationships. They desired sustained support from health care providers, specific instruction for physical activity, and reported experiences of weight-based stigma and weight-bias from partners, peers, and health care providers. Children with severe obesity have complex physical and psychological needs impacting effective management and family life. Interventions should target increased peer support, provide a tailored exercise component, and aim to reduce the effects of weight-based stigma.