Responding positively to "children who like to eat": Parents' experiences of skills-based treatment for childhood obesity

Anna Ek; Karin Nordin; Christine Delisle Nyström; Pernilla Sandvik; Karin Eli; Paulina Nowicka

doi:10.1016/j.appet.2019.104488

Responding positively to "children who like to eat": Parents' experiences of skills-based treatment for childhood obesity

Appetite. 2020 Feb 1:145:104488. doi: 10.1016/j.appet.2019.104488. Epub 2019 Oct 15.

Authors

Anna Ek¹, Karin Nordin², Christine Delisle Nyström³, Pernilla Sandvik⁴, Karin Eli⁵, Paulina Nowicka⁶

Affiliations

¹ Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden. Electronic address: anna.ek@ki.se.
² Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden. Electronic address: karin.el.nordin@sll.se.
³ Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden. Electronic address: christine.delisle.nystrom@ki.se.
⁴ Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden. Electronic address: pernilla.sandvik@ikv.uu.se.
⁵ Unit for Biocultural Variation and Obesity, Institute of Social and Cultural Anthropology, University of Oxford, Oxford, UK; Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK. Electronic address: karin.eli@anthro.ox.ac.uk.
⁶ Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden. Electronic address: paulina.nowicka@ki.se.

PMID: 31626835
DOI: 10.1016/j.appet.2019.104488

Abstract

This study aims to understand the challenges parents of preschoolers with obesity face. We assessed parents' experiences of a group treatment program focused on parenting skills; the treatment program was evaluated in a randomized controlled trial in Stockholm County. After completing the program's 10 weekly sessions, parents were invited to participate in a semi-structured interview. The interviews were audio recorded, transcribed and analyzed using thematic analysis. In total, 36 parents (67% mothers, mean age 39 years, 33% foreign background, 50% with university degree) were interviewed. Two main themes were developed: Emotional burden and Skills and strength from others. Emotional burden encompassed the parents' experiences of raising a child with obesity. Parents spoke about the difficulties of managing their child's appetite and of seeking help and treatment, as well as their feelings about the social stigma attached to obesity. Skills and strength from others encompassed the parents' experiences of participating in group treatment. Parents reported that they appreciated the practical behavior change techniques taught, especially those regarding food and how to make everyday life more predictable, and said the focus on parenting skills gave them the confidence to apply the techniques in everyday life. Parents also highlighted the strength of the group setting, saying it enabled them to discuss perceived challenges and learn from other parents. Our findings show that childhood obesity carries social and emotional implications for parents, and that an intervention that provides parents with skill-building and a discussion space can help in negotiating these implications. This suggests that childhood obesity intervention programs benefit from including a parent-based approach which offers training in parenting skills and support in managing socially and emotionally challenging situations.

Keywords: Appetite regulation; Childhood obesity; Emotion regulation; Family; Feeding; Hunger; Interventions; Stigma.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Appetite
Behavior Therapy / education
Behavior Therapy / methods*
Child
Child, Preschool
Eating / psychology*
Emotions
Female
Group Processes
Humans
Male
Parent-Child Relations
Parenting / psychology*
Pediatric Obesity / psychology*
Pediatric Obesity / therapy*
Social Stigma
Sweden