One can perhaps argue about the causes, scale, and consequences of the increasing number of overweight and obese kids and there is no doubt often parental ‘denial’ about the potential impact of excess weight on their offspring.
Yet, even amongst those, who do recognize the issue, there appears to be a widespread reluctance to seek advise from their family doctors or other health professionals.
The possible reasons for this, from the perspective of parents, was explored by Katrina Turner and colleagues from the University of Bristol, UK, in a paper just published in Family Practice.
The researchers conducted in-depth interviews with 15 parents of obese children aged 5-10 years, to explore their views and experiences of primary care childhood obesity management.
Although parents clearly saw primary care as an appropriate setting in which to treat childhood obesity, they were reluctant to consult their family doctor due to a fear of being blamed for their child’s weight and a concern about the impact of raising this issue on their child’s mental well-being.
“If we’re going to get things like ‘we are going to take your child away if they’re fat’, you’re not going to get a parent in the door. That was the worst bit of publicity they ever did [media reports about children going into care] … parents thought, I’m not going anywhere near the doctor’s surgery because they’re going to take my child away from me.”
“He [the GP] said in front of [daughter], ‘God she’s obese, how on earth can you let her get that size?’ You know, ‘You’ve just simply got to cut down, you’re giving her the wrong foods,’ and ‘Do you realise how much health issue that is?’ You know, ‘She shouldn’t be that size,’ … I took the kids out, went back in and said it was absolutely disgraceful, no way would I take the children back there again.”
In addition, the parents had considerable doubts as to whether practitioners had the knowledge, time and resources to effectively manage childhood obesity.
“I don’t think the GP has ever really had very much constructive to say about my weight … so I suppose I just think well, if I went to the GP they’d probably just say ‘well, just get them [her twin daughters] to eat less and do more.’”
Thus, there was a wide range of responses in terms of how helpful parents had found consulting a practitioner helpful.
Explicit in these findings, is how much of this parental concern leads back directly to the issue of weight bias and the culture of ‘blame and shame’ that health professionals (and everyone else) often perpetuate, largely due to their poor understanding of the complex psychosocial and biological drivers of excess weight and their inability to provide professional advise that goes beyond ‘eat-less-move-more’ platitudes.
“They [the GP] just says ‘oh, give her exercise, make her walk more.’ But she walks to school every day and its right down the bottom, and she walks home, goes to the park on her way home. “
Not surprisingly, the researchers conclude with a most important message to practitioners:
“To encourage parents to seek help about their child’s weight, practitioners should be accessible, discuss childhood obesity in a non-judgemental manner, tailor advice and give attention to broader issues, such as low self-esteem, where necessary.”
Unfortunately, we are still graduating health professionals who do not have the least idea on how to begin addressing this issue.
Turner KM, Salisbury C, & Shield JP (2011). Parents’ views and experiences of childhood obesity management in primary care: a qualitative study. Family practice PMID: 22117082
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