Parents' views and experiences when their preschool child is identified as overweight: a qualitative study in primary care

Background. Prevalence of overweight in children has increased significantly in many countries in the past decades. Few parents identify their own children as overweight, especially very young children. Motivating parents is difficult, and interventions to attain normal weight often fail. Objective. To explore parents' views and experiences when health professionals identify their preschool child as overweight. Methods. In-depth interviews were held with parents of 10 overweight children aged 2.5-5.5 years. Parents were recruited at well child clinics in rural parts of eastern Norway. Interviews were recorded digitally, transcribed verbatim and analysed thematically. Results. Parents presented themselves and their toddlers as vulnerable. To protect their child from developing low self-esteem and eating disorders, some parents preferred their child not to be present when discussing overweight. Growth charts were looked upon as objective and useful. Parents talked readily about their own weight experiences. Being overweight themselves represented both a barrier to, and motivation for, dealing with their toddler's overweight. Parents appreciated support from professionals in kindergarten, but grandparents often undermined the parents' effort to make changes. Conclusions. Early childhood overweight should be addressed in a sensitive and respectful manner and should consider whether the index child should be present during discussion. It may be helpful for clinicians to discuss parents' own weight and dieting experiences and concerns about eating disorders. All the child's caretakers should be considered a target for intervention, and grandparents and kindergarten professionals should be included.