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Treating Obesity 203
about their child’s weight as a way of beginning a Portion sizes eaten by child – are they
discussion. A measurement of the child’s weight appropriate or do they need to be reduced?
and height/length could then be offered. Showing
a parent how the BMI of their overweight/obese Speed of eating – children who eat quickly tend
child relates to the normal range by using the BMI to eat larger quantities of food
centile chart is a good way to continue the
discussion. Child’s enjoyment of food vs. enjoyment of
non-food activities
Unless parents acknowledge that there is a
problem and are ready to change their lifestyle Family attitude to food and food as rewards,
there is little that can be achieved for an overweight treats or for comfort
or obese preschool or primary school child.
Family activities that can be introduced to
Supporting parents to make lifestyle replace food and drink-based activities
changes
Current family lifestyle balance between
Lifestyle changes for the whole family are physical activities and sedentary activities
preferable to just targeting the behaviour of the
overweight or obese child on their own. When Overweight child’s aspirations to try new
lifestyle changes become a normal part of their non-food-related activities
family life they are more likely to be maintained
long term. Each family will probably have a Increasing children’s self-esteem around
preference for either: non-weight-related activities or skills. Praise
from parents when achievements are made is
●● a single family intervention or important.
●● a multi-family group programme although Once contributing factors have been identified,
accessibility to group programmes may be limited. families can explore which of these factors they feel
they may be able to change. The barriers to making
In most cases the cause of the obesity will be changes may be considerable for some families
multifactorial and a single solution will not suit because of:
every family. Parents are likely to be aware of
factors but they may involve emotional issues, ●● the family lifestyle
making change seem more difficult (Pagnini et al. ●● lack of knowledge of what a nutritions balanced
2007).
diet is
Discussion points to explore with a ●● lack of cooking skills or facilities to prepare
family with an overweight or obese
child: lower energy foods
●● housing and facilities in the local environment
Weight change – what are the aims for this ●● limited finances.
child/family?
There will be pros and cons, and solutions may not
Adolescent growth spurt – has this occurred yet always be clear cut. For instance, excess sedentary
and how does this affect weight change goals? behaviour and lack of physical activity could be a
major factor for a family living in a cramped flat in a
Planned meal and planned snack routine rather high-rise building with no access to a playground or
than allowing grazing on food and drinks garden. Taking a young child to play outside would
impact on the time a busy mother might have to
Snacks – changes towards low energy, higher prepare ideal foods. A carefully structured assessment
nutrient planned snacks of need will enable healthcare professionals to support
parents in balancing needs and priorities.
