Obesity: It's All in the Family

Obesity in children is a very complex problem. How children eat and what they believe about food and obesity is largely determined in their family units. Obesity is distributed disproportionately and seems to concentrate in economically challenged populations. Dysfunctional family dynamics can complicate treatment, frustrate clinicians, and create roadblocks for children who need to lose weight. In addition, public health communication strategies usually encourage behavioral changes; however, campaigns often mix behavioral and social messages associated with overweight and obesity. Children find this confusing. Clinicians usually understand very little about how families understand and communicate information about weight and health.

Researchers in Australia set out to determine how parents and children deal with weight- and health-related issues in their homes. They interviewed 150 family groups, defining a family as at least 1 parent and 1 child.

The researchers identified 3 thematic clusters after data analysis:

• Parents and children both see obesity as a failure of personal responsibility. Parents tend to focus on the negative health implications, but children focus on the negative social implications.
• Parents tend to apply moral frameworks to obesity. Perceiving themselves responsible, they often used scare tactics and negatively-framed messages to convey a message of danger. Children preferred positively-framed messages encouraging healthy behaviors.
• Parents and children saw exercise and healthy eating as a means to achieve weight loss as opposed to a mechanism to achieve and maintain good health.

The authors indicate that simplistic and negatively (or morally) framed messages can be harmful, precipitating fad dieting or a focus on weight over health. Both parents and children seemed to be easily influenced toward these unintended consequences. Public health campaigns may deliver messages that focus on “normal” weight, and imply personal responsibility and blame. The best messages are pro-health, not anti-obesity.

This study appears in the August 2014 issue of Social Science & Medicine.