Skip to main content
Top
Published in: BMC Public Health 1/2014

Open Access 01-12-2014 | Research article

“It’s a balance of just getting things right”:mothers’ views about pre-school childhood obesity and obesity prevention in Scotland

Authors: Flora Douglas, Julia Clark, Leone Craig, Jonina Campbell, Geraldine McNeill

Published in: BMC Public Health | Issue 1/2014

Login to get access

Abstract

Background

The high prevalence of childhood obesity is a concern for policy makers and health professionals, leading to a focus on early prevention. The beliefs and perspectives of parents about early childhood obesity, and their views and opinions about the need for weight management interventions for this age group are poorly understood.

Methods

A formative qualitative focus group study with parents of pre-school children took place in eight community-based locations throughout North-East Scotland to explore their ideas about the causes of early childhood obesity, personal experiences of effective weight management strategies, and views about the format and content of a possible child-orientated weight management programme. Study participants were recruited via pre-school nurseries.

Results

Thirty-four mothers (median age 37 years) took part in the study, but only two believed their child had a weight problem. Participants (who focussed primarily on dietary issues) expressed a strong sense of personal responsibility to ‘get the balance right’ regarding their child’s weight, and were generally resistant to the idea of attending a weight management programme aimed at very young children. At the same time, they described a range of challenges to their weight management intentions. These included dealing with intrinsic uncertainties such as knowing when to stop ‘demand feeding’ for weight gain, and judging appropriate portion sizes - for themselves and their children. In addition they faced a range of extrinsic challenges associated with complex family life, i.e. catering to differing family members dietary needs, food preferences, practices and values, and keeping their ‘family food rules’ (associated with weight management) when tired or pressed for time.

Conclusions

The findings have important implications for health professionals and policy makers wishing to engage with parents on this issue, or who are currently developing ‘family-centred’ early childhood weight management interventions. The challenge lies in the fact that mothers believe themselves to be the primary (and capable) agents of obesity prevention in the early years – but, who are at the same time, attempting to deal with many mixed and conflicting messages and pressures emanating from their social and cultural environments that may be undermining their weight management intentions.
Literature
1.
go back to reference Voigt K: Childhood obesity and restrictions of parental liberty. A response to“ paternalism, obesity, and tolerable levels of risk”. Democracy and Education. 2012, 20 (1): 8- Voigt K: Childhood obesity and restrictions of parental liberty. A response to“ paternalism, obesity, and tolerable levels of risk”. Democracy and Education. 2012, 20 (1): 8-
2.
go back to reference Merry MS: Paternalism, obesity, and tolerable levels of risk. Democracy and Education. 2012, 20 (1): 3- Merry MS: Paternalism, obesity, and tolerable levels of risk. Democracy and Education. 2012, 20 (1): 3-
3.
go back to reference Maher J, Fraser S, Wright J: Framing the mother: childhood obesity, maternal responsibility and care. J Gend Stud. 2010, 19 (3): 233-247.CrossRef Maher J, Fraser S, Wright J: Framing the mother: childhood obesity, maternal responsibility and care. J Gend Stud. 2010, 19 (3): 233-247.CrossRef
4.
go back to reference Brún AD, McCarthy M, McKenzie K, McGloin A: “Fat is your fault”: Gatekeepers to health, attributions of responsibility and the portrayal of gender in the Irish media representation of obesity. Appetite. 2012, 62: 17-26.CrossRefPubMed Brún AD, McCarthy M, McKenzie K, McGloin A: “Fat is your fault”: Gatekeepers to health, attributions of responsibility and the portrayal of gender in the Irish media representation of obesity. Appetite. 2012, 62: 17-26.CrossRefPubMed
5.
go back to reference Coveney J: Food, Morals and Meaning: The Pleasure and Anxiety of Eating. 2006, London: Routledge, 2 Coveney J: Food, Morals and Meaning: The Pleasure and Anxiety of Eating. 2006, London: Routledge, 2
10.
go back to reference Tones K, Green J: A Systematic Approach to Health Promotion Planning Chapter 4. 2004, Health Promotion: Planning and Strategies London: Sage Publications, 105-142. Tones K, Green J: A Systematic Approach to Health Promotion Planning Chapter 4. 2004, Health Promotion: Planning and Strategies London: Sage Publications, 105-142.
11.
go back to reference Best A, Stokols D, Green L, Leischow S, Holmes B, Buchholz K: An integrative framework for community partnering to translate theory into effective health promotion strategy. Am J Health Promot. 2003, 18 (2): 168-176.CrossRefPubMed Best A, Stokols D, Green L, Leischow S, Holmes B, Buchholz K: An integrative framework for community partnering to translate theory into effective health promotion strategy. Am J Health Promot. 2003, 18 (2): 168-176.CrossRefPubMed
12.
go back to reference Green LW, Kreuter MW: Health Promotion Planning: An Educcational and Ecological Approach. 1999, Boston: Mayfield, 3 Green LW, Kreuter MW: Health Promotion Planning: An Educcational and Ecological Approach. 1999, Boston: Mayfield, 3
13.
go back to reference De Leeuw E: Health policy, epidemiology and power: the interest web. Health Promot Int. 1993, 8 (1): 49-52.CrossRef De Leeuw E: Health policy, epidemiology and power: the interest web. Health Promot Int. 1993, 8 (1): 49-52.CrossRef
14.
go back to reference Rittel HW, Webber M: Dilemmas in a general theory of planning. Policy Sciences. 1973, 4: 155-169.CrossRef Rittel HW, Webber M: Dilemmas in a general theory of planning. Policy Sciences. 1973, 4: 155-169.CrossRef
15.
go back to reference Schubert L, Gallegos D, Foley W, Harrison C: Re-imagining the ‘social’ in the nutrition sciences. Public Health Nutr. 2012, 15 (2): 352-359.CrossRefPubMed Schubert L, Gallegos D, Foley W, Harrison C: Re-imagining the ‘social’ in the nutrition sciences. Public Health Nutr. 2012, 15 (2): 352-359.CrossRefPubMed
16.
go back to reference Strauss A, Corbin J: Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory. 1998, Thousand Oaks: Sage Strauss A, Corbin J: Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory. 1998, Thousand Oaks: Sage
17.
go back to reference Ritchie J, Lewis J: Qualitative Research Practice. 2003, 1 Ritchie J, Lewis J: Qualitative Research Practice. 2003, 1
18.
go back to reference Greener J, Douglas F, van Teijlingen E: More of the same? Conflicting perspectives of obesity causation and intervention amongst overwieght people, health professionals and policy makers. Soc Sci Med. 2010, 70: 1042-1049.CrossRefPubMed Greener J, Douglas F, van Teijlingen E: More of the same? Conflicting perspectives of obesity causation and intervention amongst overwieght people, health professionals and policy makers. Soc Sci Med. 2010, 70: 1042-1049.CrossRefPubMed
19.
go back to reference McPhail D: Resisting biopedagogies of obesity in a problem population: understandings of healthy eating and healthy weight in a Newfoundland and Labrador community. Critical Public Health. 2013, 23 (3): 1-15.CrossRef McPhail D: Resisting biopedagogies of obesity in a problem population: understandings of healthy eating and healthy weight in a Newfoundland and Labrador community. Critical Public Health. 2013, 23 (3): 1-15.CrossRef
20.
go back to reference Vereecken C, Rovner A, Maes L: Associations of parenting styles, parental feeding practices and child characteristics with young children’s fruit and vegetable consumption. Appetite. 2010, 55 (3): 589-596.CrossRefPubMed Vereecken C, Rovner A, Maes L: Associations of parenting styles, parental feeding practices and child characteristics with young children’s fruit and vegetable consumption. Appetite. 2010, 55 (3): 589-596.CrossRefPubMed
21.
go back to reference Rodgers RF, Paxton SJ, Massey R, Campbell KJ, Wertheim EH, Skouteris H, Gibbons K: Maternal feeding practices predict weight gain and obesogenic eating behaviors in young children: a prospective study. Int J Behav Nutr Phys Act. 2013, 10 (1): 24-CrossRefPubMedPubMedCentral Rodgers RF, Paxton SJ, Massey R, Campbell KJ, Wertheim EH, Skouteris H, Gibbons K: Maternal feeding practices predict weight gain and obesogenic eating behaviors in young children: a prospective study. Int J Behav Nutr Phys Act. 2013, 10 (1): 24-CrossRefPubMedPubMedCentral
22.
go back to reference Birch LL, Fisher JO: Mothers’ child-feeding practices influence daughters’ eating and weight. Am J Clin Nutr. 2008, 71 (5): 1054-1061. Birch LL, Fisher JO: Mothers’ child-feeding practices influence daughters’ eating and weight. Am J Clin Nutr. 2008, 71 (5): 1054-1061.
23.
go back to reference Lang T, Rayner G: Overcoming policy cacophony on obesity: an ecological public health framework for policy makers. Obes Rev. 2007, 8 (Suppl. 1): 165-181.CrossRefPubMed Lang T, Rayner G: Overcoming policy cacophony on obesity: an ecological public health framework for policy makers. Obes Rev. 2007, 8 (Suppl. 1): 165-181.CrossRefPubMed
24.
go back to reference Gard M: Obesity and Public Policy: Thinking Clearly and Treading Carefully. 2007, Edinburgh: Scottish Council Foundation Gard M: Obesity and Public Policy: Thinking Clearly and Treading Carefully. 2007, Edinburgh: Scottish Council Foundation
25.
go back to reference Swinburn BA, Sacks G, Hall KD, McPherson K, Finegood DT, Moodie ML, Gortmaker SL: The global obesity pandemic: shaped by global drivers and local environments. Lancet. 2011, 378 (9793): 804-814.CrossRefPubMed Swinburn BA, Sacks G, Hall KD, McPherson K, Finegood DT, Moodie ML, Gortmaker SL: The global obesity pandemic: shaped by global drivers and local environments. Lancet. 2011, 378 (9793): 804-814.CrossRefPubMed
26.
go back to reference Puterbaugh JS: The emperor’s tailors: the failure of the medical weight loss paradigm and its causal role in the obesity of America. Diabetes Obes Metabol. 2009, 11: 557-570.CrossRef Puterbaugh JS: The emperor’s tailors: the failure of the medical weight loss paradigm and its causal role in the obesity of America. Diabetes Obes Metabol. 2009, 11: 557-570.CrossRef
27.
go back to reference Butland B, Jebb S, Kopelman P, McPherson K, Thomas S, Mardell J, Parry V: Tackling Obesities: Future Choice – Modelling future trends on obesity and their impact on health. 2007, Government Office for Science Butland B, Jebb S, Kopelman P, McPherson K, Thomas S, Mardell J, Parry V: Tackling Obesities: Future Choice – Modelling future trends on obesity and their impact on health. 2007, Government Office for Science
28.
go back to reference Pagnini D, King L, Booth S, Wilkenfeld R, Booth M: The weight of opinion on childhood obesity: recognizing complexity and supporting collaborative action. Int J Pediatr Obes. 2009, 4 (4): 233-241.CrossRefPubMed Pagnini D, King L, Booth S, Wilkenfeld R, Booth M: The weight of opinion on childhood obesity: recognizing complexity and supporting collaborative action. Int J Pediatr Obes. 2009, 4 (4): 233-241.CrossRefPubMed
29.
go back to reference Southwell O, Fox JR: Maternal perceptions of overweight and obesity in children: a grounded theory study. Br J Health Psychol. 2011, 16 (3): 626-641.CrossRefPubMed Southwell O, Fox JR: Maternal perceptions of overweight and obesity in children: a grounded theory study. Br J Health Psychol. 2011, 16 (3): 626-641.CrossRefPubMed
30.
go back to reference Jones AR, Parkinson KN, Drewett RF, Hyland RM, Pearce MS, Adamson AJ: Parental perceptions of weight status in children: the Gateshead millennium study. Int J Obes. 2011, 35 (7): 953-962.CrossRef Jones AR, Parkinson KN, Drewett RF, Hyland RM, Pearce MS, Adamson AJ: Parental perceptions of weight status in children: the Gateshead millennium study. Int J Obes. 2011, 35 (7): 953-962.CrossRef
31.
go back to reference Parkinson K, Drewett R, Jones A, Adamson A: Mothers’ judgements about their child’s weight: distinguishing facts from values. Child Care Health Dev. 2012, 39 (5): 722-727.CrossRefPubMed Parkinson K, Drewett R, Jones A, Adamson A: Mothers’ judgements about their child’s weight: distinguishing facts from values. Child Care Health Dev. 2012, 39 (5): 722-727.CrossRefPubMed
33.
go back to reference Chaimovitz R, Issenman R, Moffat T, Persad R: Body perception: do parents, their children, and their children’s physicians perceive body image differently?. J Pediatr Gastroenterol Nutr. 2008, 47 (1): 76-80.CrossRefPubMed Chaimovitz R, Issenman R, Moffat T, Persad R: Body perception: do parents, their children, and their children’s physicians perceive body image differently?. J Pediatr Gastroenterol Nutr. 2008, 47 (1): 76-80.CrossRefPubMed
34.
go back to reference Mathieu M, Drapeau V, Tremblay A: Parental misperception of their child’s body weight status impedes the assessment of the child’s lifestyle behaviors. Int J Pediatr. 2010, Article No 306703 1-9- Mathieu M, Drapeau V, Tremblay A: Parental misperception of their child’s body weight status impedes the assessment of the child’s lifestyle behaviors. Int J Pediatr. 2010, Article No 306703 1-9-
35.
go back to reference Towns N, D’Auria J: Parental perceptions of their child’s overweight: an integrative review of the literature. J Pediatr Nurs. 2009, 24 (2): 115-130.CrossRefPubMed Towns N, D’Auria J: Parental perceptions of their child’s overweight: an integrative review of the literature. J Pediatr Nurs. 2009, 24 (2): 115-130.CrossRefPubMed
36.
go back to reference Zhu D, Norman IJ, While AE: Nurses’ misperceptions of weight status associated with their body weight, demographics and health status. Public Health Nutr. 2013, 17: 1-10. Zhu D, Norman IJ, While AE: Nurses’ misperceptions of weight status associated with their body weight, demographics and health status. Public Health Nutr. 2013, 17: 1-10.
37.
go back to reference Guthman J: Fatuous measures: the artifactual construction of the obesity epidemic. Crit Publ Health. 2013, 23 (3): 1-11.CrossRef Guthman J: Fatuous measures: the artifactual construction of the obesity epidemic. Crit Publ Health. 2013, 23 (3): 1-11.CrossRef
39.
go back to reference Nutbeam D, Harris E: Theory in a Nutshell: A Practical Guide to Health Promotion Theories. 1999, Sydney: McGraw-Hill Companies Nutbeam D, Harris E: Theory in a Nutshell: A Practical Guide to Health Promotion Theories. 1999, Sydney: McGraw-Hill Companies
40.
go back to reference Levitsky DA, Pacanowski CR: Free will and the obesity epidemic. Public Health Nutr. 2011, 15 (1): 126-CrossRefPubMed Levitsky DA, Pacanowski CR: Free will and the obesity epidemic. Public Health Nutr. 2011, 15 (1): 126-CrossRefPubMed
42.
go back to reference Brownell KD, Horgen KB: Food Fight: The Inside Story of the Food Industry, America’s Obesity Crisis and What We Can Do About It. 2004, Chicago: Contemporary Books Brownell KD, Horgen KB: Food Fight: The Inside Story of the Food Industry, America’s Obesity Crisis and What We Can Do About It. 2004, Chicago: Contemporary Books
44.
go back to reference Schwartz C, Madrelle J, Vereijken CMJL, Weenen H, Nicklaus S, Hetherington MM: Complementary feeding and “donner les bases du goût” (providing the foundation of taste). A qualitative approach to understand weaning practices, attitudes and experiences by French mothers. Appetite. 2013, 71 (0): 321-331.CrossRefPubMed Schwartz C, Madrelle J, Vereijken CMJL, Weenen H, Nicklaus S, Hetherington MM: Complementary feeding and “donner les bases du goût” (providing the foundation of taste). A qualitative approach to understand weaning practices, attitudes and experiences by French mothers. Appetite. 2013, 71 (0): 321-331.CrossRefPubMed
47.
go back to reference Jenkin G, Signal L, Thomson G: Framing obesity: the framing contest between industry and public health at the New Zealand inquiry into obesity. Obes Rev. 2011, 12 (12): 1022-1030.CrossRefPubMed Jenkin G, Signal L, Thomson G: Framing obesity: the framing contest between industry and public health at the New Zealand inquiry into obesity. Obes Rev. 2011, 12 (12): 1022-1030.CrossRefPubMed
48.
go back to reference Popkin B: The World is Fat: The Fads, Trends, Policies and Products That Are Making Are Fattening the Human Race. 2009, London: Penguin Books, 1 Popkin B: The World is Fat: The Fads, Trends, Policies and Products That Are Making Are Fattening the Human Race. 2009, London: Penguin Books, 1
49.
go back to reference Shelley JJ: Addressing the policy cacophony does not require more evidence: an argument for reframing obesity as caloric overconsumption. BMC Public Health. 2012, 12 (1): 1042-CrossRefPubMedPubMedCentral Shelley JJ: Addressing the policy cacophony does not require more evidence: an argument for reframing obesity as caloric overconsumption. BMC Public Health. 2012, 12 (1): 1042-CrossRefPubMedPubMedCentral
50.
go back to reference Nestle M: Food Politics: How The Food Industry Influences Nutrition and Health. 2003, London: Universtiy of California Press Nestle M: Food Politics: How The Food Industry Influences Nutrition and Health. 2003, London: Universtiy of California Press
51.
go back to reference Westerterp KR, Speakman JR: Physical activity energy expenditure has not declined since the 1980s and matches energy expenditures of wild mammals. Int J Obes. 2008, 32 (8): 1256-1263.CrossRef Westerterp KR, Speakman JR: Physical activity energy expenditure has not declined since the 1980s and matches energy expenditures of wild mammals. Int J Obes. 2008, 32 (8): 1256-1263.CrossRef
52.
go back to reference Thomas D, Bouchard C, Church T, Slentz C, Kraus W, Redman L, Silva AM, Vossen M, Westerup K, Heymsfield SB: Why do individuals not lose more weight from an exercise intervention at a defined dose? An energy balance analysis. Obes Rev. 2012, 13 (10): 835-847.CrossRefPubMedPubMedCentral Thomas D, Bouchard C, Church T, Slentz C, Kraus W, Redman L, Silva AM, Vossen M, Westerup K, Heymsfield SB: Why do individuals not lose more weight from an exercise intervention at a defined dose? An energy balance analysis. Obes Rev. 2012, 13 (10): 835-847.CrossRefPubMedPubMedCentral
53.
go back to reference Caudwell P, Gibbons C, Finlayson G, Näslund E, Blundell J: Physical Activity, Energy Intake, and Obesity: The Links Between Exercise and Appetite. Curr Obes Rep. 2013, 1-6. Caudwell P, Gibbons C, Finlayson G, Näslund E, Blundell J: Physical Activity, Energy Intake, and Obesity: The Links Between Exercise and Appetite. Curr Obes Rep. 2013, 1-6.
54.
go back to reference Swinburn B: Obesity Prevention in Children and Adolescents. Child Adolesc Psychiatr Clin N Am. 2009, 18 (1): 209-223.CrossRefPubMed Swinburn B: Obesity Prevention in Children and Adolescents. Child Adolesc Psychiatr Clin N Am. 2009, 18 (1): 209-223.CrossRefPubMed
55.
go back to reference Willmott M, Nelson W: Complicated lives: The Malaise of Modernity. 2005, Chichester: John Wiley and Sons, Ltd Willmott M, Nelson W: Complicated lives: The Malaise of Modernity. 2005, Chichester: John Wiley and Sons, Ltd
56.
go back to reference Carrigan M, Szmigin I, Leek S: Managing routine food choices in UK families: The role of convenience consumption. Appetite. 2006, 47 (3): 372-383.CrossRefPubMed Carrigan M, Szmigin I, Leek S: Managing routine food choices in UK families: The role of convenience consumption. Appetite. 2006, 47 (3): 372-383.CrossRefPubMed
57.
58.
go back to reference Jabs J, Devine CM, Bisogni CA, Farrell TJ, Jastran M, Wethington E: Trying to Find the Quickest Way: Employed Mothers’ Constructions of Time for Food. J Nutr Educ Behav. 2007, 39 (1): 18-25.CrossRefPubMed Jabs J, Devine CM, Bisogni CA, Farrell TJ, Jastran M, Wethington E: Trying to Find the Quickest Way: Employed Mothers’ Constructions of Time for Food. J Nutr Educ Behav. 2007, 39 (1): 18-25.CrossRefPubMed
59.
go back to reference Gatley A, Caraher M, Lang T: A qualitative, cross cultural examination of attitudes and behaviour in relation to cooking habits in France and Britain. Appetite. 2014, 75: 71-81.CrossRefPubMed Gatley A, Caraher M, Lang T: A qualitative, cross cultural examination of attitudes and behaviour in relation to cooking habits in France and Britain. Appetite. 2014, 75: 71-81.CrossRefPubMed
60.
go back to reference Haworth J: Work, Leisure and Well-being in changing social conditions. Well-being: Individual, community and social perspectives. Edited by: Haworth J, Hart G. 2012, Houndsmills Basingstoke: Palgrave MacMillan, 245-259. 2 Haworth J: Work, Leisure and Well-being in changing social conditions. Well-being: Individual, community and social perspectives. Edited by: Haworth J, Hart G. 2012, Houndsmills Basingstoke: Palgrave MacMillan, 245-259. 2
61.
go back to reference Kawachi I, Kennedy BP: The Health of Nations: Why Inequalities is Harmful to Your Health. 2002, New York: New Press Kawachi I, Kennedy BP: The Health of Nations: Why Inequalities is Harmful to Your Health. 2002, New York: New Press
62.
go back to reference Patel R: Stuffed and starved: From farm to fork, the hidden battle for the world food system. 2007, London: Portobello Books Patel R: Stuffed and starved: From farm to fork, the hidden battle for the world food system. 2007, London: Portobello Books
63.
go back to reference Skelton J, Buehler C, Irby M, Grzywacz J: Where are family theories in family-based obesity treatment & quest;: conceptualizing the study of families in pediatric weight management. Int J Obes. 2012, 36 (7): 891-900.CrossRef Skelton J, Buehler C, Irby M, Grzywacz J: Where are family theories in family-based obesity treatment & quest;: conceptualizing the study of families in pediatric weight management. Int J Obes. 2012, 36 (7): 891-900.CrossRef
64.
go back to reference Khandpur N, Blaine RE, Fisher JO, Davison KK: Fathers’ child feeding practices: A review of the evidence. Appetite. 2014, 78: 110-121.CrossRefPubMed Khandpur N, Blaine RE, Fisher JO, Davison KK: Fathers’ child feeding practices: A review of the evidence. Appetite. 2014, 78: 110-121.CrossRefPubMed
65.
68.
go back to reference Conklin AI, Forouhi NG, Suhrcke M, Surtees P, Wareham NJ, Monsivais P: Socioeconomic status, financial hardship and measured obesity in older adults: a cross-sectional study of the EPIC-Norfolk cohort. BMC Public Health. 2013, 13 (1): 1039-CrossRefPubMedPubMedCentral Conklin AI, Forouhi NG, Suhrcke M, Surtees P, Wareham NJ, Monsivais P: Socioeconomic status, financial hardship and measured obesity in older adults: a cross-sectional study of the EPIC-Norfolk cohort. BMC Public Health. 2013, 13 (1): 1039-CrossRefPubMedPubMedCentral
69.
go back to reference Katikireddi SV, Higgins M, Smith KE, Williams G: Health inequalities: the need to move beyond bad behaviours. J Epidemiol Community Health. 2013, 67 (9): 715-716.CrossRefPubMed Katikireddi SV, Higgins M, Smith KE, Williams G: Health inequalities: the need to move beyond bad behaviours. J Epidemiol Community Health. 2013, 67 (9): 715-716.CrossRefPubMed
Metadata
Title
“It’s a balance of just getting things right”:mothers’ views about pre-school childhood obesity and obesity prevention in Scotland
Authors
Flora Douglas
Julia Clark
Leone Craig
Jonina Campbell
Geraldine McNeill
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2014
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-14-1009

Other articles of this Issue 1/2014

BMC Public Health 1/2014 Go to the issue