The Support Needs of Parents of Overweight Children

1
The Support Needs of Parents of Overweight
Children
Dr Penny Curtis Ms Helen Stapleton Ms Fiona
Wilson
SHSRC     Sheffield Health Social Research
Consortium 
2
Background

• Approximately 12,000 obese children in Sheffield
  http//www.sheffield.nhs.uk/southeastpct/resources
  /sespctpress200504.pdf
• The first generation of children to die before
  their parents (House of Commons Health Committee,
  2004)
• Draft guidelines for management of obesity
  emphasise whole family support (NICE
  consultation, March 2006)
• Little evidence of parental understandings and
  help-seeking behaviours (Edmunds, 2005 Jackson,
  2005)

3
Aims

• How do parents explain/understand childs weight
• Experience of help-seeking
• Perceived support needs

4
Methodology

• Qualitative, longitudinal study to capture
  changes in parental perceptions of childs weight
  problem and support needs over time.
• Working with SHINE (Self Help, Independence,
  Nutrition and Exercise) - a community-based
  obesity intervention programme in Sheffield.
• Parents interviewed at beginning and end of 12
  week programme.
• Focus is on initial interviews with 15 parents at
  the start of 12 week programme

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FINDINGS THREE KEY THEORETICAL THEMES
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I mean, he was swimming five times a week and
theyre like two hour sessions, cause when
theyre trainingbut I was looking and thinking
the weights not coming off, why? And thats why
I took him to the doctors. B101
7
thats what makes me wonder if theres summat
wrong. Yeah, do you know like cause they eat
exactly the same foods and he (thin sibling) eats
more but hes, he stays right thin so to me its
gotta be summat in their body whats different?
C102
8
Cause I was saying I shouldnt have let you
get like this. B103Theres a
self-judgemental aspect to it (re childs
weight). B110
9
I dont know, theres always something in back
of me mind Im thinking could it have been
something to do with all the medication he had
and various, cause it were all operations And
then after that he started school and he just
steadily gained weight and it were just really
strange, you know? B102
10
All the women on her Dads side are all, theyve
got like big hips and, well, I think its just
summat in their (make up). B106 Erm, so
were not meant to be skinny people. B113
11
So, erm, there is a lot, all my side of the
family have got diabetes, I hant got it, but all
me Dads side and I think its quite scary
because it is increasing. B102I know myself
cause Im overweight walking places I get out of
breath and hes starting, hes getting chesty as
well. B114
12
2. Family Dynamics

• Family members eating practices, weight
  histories and health problems

13

• I couldnt stop myself, it werent in my nature
  (laugh) but while I were taking laxatives, er,
  eating food and, I mean it were just like I, I
  must have cried for help. C102

14
Now thats summat Ive got to watch out with
Mick, if he loses his weight will he know when to
stop. C102
15

• My wife wasnt very well at the time, she was
  suffering from depression and Id got a lot on my
  plate so a lot of things that perhaps should have
  been done werent. B108

16

• Youve failed because she, she has got this
  problem. Well, even with the bullying Ive, Ive
  felt that perhaps, I could support her a bit
  more. But, I dont know how to handle it because
  I went through a similar sort of thing as well
  B105

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Trajectories of Help-Seeking

• Schools
• GPs
• Hospital Consultants
• Dieticians
• Counsellors

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• Help-Seeking Schools

19
Yeah, er, we have actually its been, which
has been really good, erm, it took some time
before we got help but, yeah, that was
forthcoming. School were, were pretty good,
eventually. B109

• Every time Ive phoned up the teacher, the
  person Ive spoken to, is really positive and
  says he will sort it and he always phones me back
  and says what hes actually done. B107

20
I think it childs weight has obscured a
lot. Yes. the bullying and her emotional
problems have obscured a lot of her weight
problems, definitely. Cause theres got to be a
level, hasnt there, where you say this is more
important. And you know her getting effectively
very, very depressed and very anxious, at what
eleven, thirteen years old, thats a horrible
thing for a child to go through. B109
21
Nobodys phoned, cause like, when a childs
like that in school - got summat seriously wrong
with em - you think theyd be like in touch in
a way weve never seen none of the nurse from
the school, you know what I mean?... And
really, we should, I think. B104

22

• Help-Seeking GPs

23

• Well, I thought, well, if theres something
  wrong, does he need any help, is it his thyroids
  or something. Thats why I got him checked out.
  B112

24

• I just think hes a lovely man, but you know, he
  was just Dont feed her. Just cut down her
  food. B103 Last time I went he GP made me
  feel as though it childs obesity were my fault
  and I think thats why I never went back. C102

25

• Help-Seeking Hospital Consultants

26
Really I just think you were left. I think I
was just left to get on with it. B103Theyre
on about children and obesity and everything but
thats where it stops. Theres no offer of any
help, as we found out from us GP or at hospital.
B107
27

• Help-Seeking Dieticians

28
I found that whole thing much of a veneer and
nothing of substance. There was no real
substance in terms of actual help or even a
concern to help. B110Ive got to look at his
portion size more. B101Because she was a fat
kid (it was) How much sugar do you put on
(cereal). I said We dont put sugar on I
think she (dietician) just assumed and I just
said to (husband) I will never go again. I will
never, ever see a dietician again. B103
29

• Help-Seeking Counsellors

30
Nothing was really addressed, it was quite
airy-fairy talk between us all. There was nothing
really there to be able to latch on to.
B109He son relied on that couple of times a
week seeing her and sometimes hed go and shed
say Look Julian, Ive got an emergency, or if
she were off sick he couldnt see her. It
were like nothings been solid for him. B112
31
Summary

• Help-seeking, triggered by bullying and the
  transition to secondary school
• GPs first point of contact for help but lack
  resources
• Lack of joined-up working between agencies
• Interactions perceived as judgemental
  unsupportive and
• Interventions lacked continuity
• Little recognition of family understandings or
  family biography