Obesity treatment—more than food and exercise: a qualitative study exploring obese adolescents’ and their parents’ views on the former's obesity

Figures & data

Table I. List of participations.

Adolescents				Parents/grandparents
Gender	Age (year) at camp start	Weight (kg) at camp start	Weight loss (kg) at the camp	Mother (M) Father (F) Grandparents (GP)
♂	14	95	5	M, F
♂	14	112	7	GP
♂	15	123	6	M
♂	15	95	3	M
♂	15	118	4	M, F
♂	15	95	6	M
♂	16	87	4	M
♀	14	73	3	M, F
♀	14	92	5	M, F
♀	14	80	3	GP
♀	15	103	4	M
♀	15	83	4	F
♀	15	95	5	M
♀	16	86	4	M, F
♀	16	91	6	M

Table II. Themes of the interview guide.

Topics of interests, adolescents and parents

• Obesity anamnesis; when and why, possible episodes related to the obesity.

• Attitudes to food; amount and type of food intake, food bought in secret.

• Attitudes to exercise; type and time spent on exercise.

• Previous attempts to lose weight; why, how, motivation to do so.

Related to the adolescents

• Parents’ and friends involvement in the handling of the obesity.

• Hopes for the future regarding the obesity.

Related to the parents

• The obese child's motivation to lose weight.

• Parents’ support; what do they do, could they do more/something else.

Note: This is not to be seen as questions but as themes the interviewer covered while interviewing.

Table III. Adolescents. Findings of the structural analysis with units of significance, themes and subthemes and examples of meaningful units shown as quotations derived from the text in the naive reading.

Units of meaning—what they say (quotations)	Units of significance—what it speaks	Themes and subthemes
“They [parents] know that I sometimes buy unhealthy food, but not that I do it three or four times a day”.“She [mother] would be furious if she knew how much food I buy so I don't tell her anything. You know, I wish I did not eat it but I just cannot stop doing so”.“I wish I didn't do it but I just forget everything about losing weight when I'm buying it”.“Once I stopped eating unhealthy food for nearly one week. I was really proud of myself. But it kind of stopped after that week”.	Large amounts of unhealthy food intake. Ashamed of eating in such a way and hide it from parents.Wish current eating habits were healthier.	Attitudes towards diet Unhealthy food habits.Ashamed of this behaviour and want to change it.
“I often think at night that tomorrow I am going to go for a run. And I really mean it … but then something else comes up and I don't”. “I have nearly always been a member of a sports club … in the last three years I have tried perhaps six different clubs but I didn't like them. Now I'm using the gym”. “I go to the gym … Well, I have only been there a few times this year. I am going to use it more, I am sure”. “I don't think I get enough exercise but I have physical education in school and sometimes I go to the gym”.	Exaggerate the daily level of exercise—perceive it as moderate. Wish current exercising habits were healthier. Associate exercise with formalised sport or the gym.	Attitudes towards exercise Discrepancy between the actual level of exercise and the perception of it. Want to increase level of exercise.Exercise is perceived as formal and club-based.
“If I am gaining weight it is because I have been lazy and not been pulling myself together”. “My parents have tried to help me although not very well I think. But I am 15 now and I should be able to control myself.” “Once I lost three kilos and I was much happier and also a little bit proud. But then some problems came up and I did not have energy to do the right things. So it is my own fault, I guess I am weak.” “When you are slim everything is much easier. No one looks at you, your clothes fit”.	Feel guilty for being obese and accuse themselves for not being capable of reducing weight. Believe life at normal weight is better.	Responsibility and obesity Blame themselves for being obese. Associate a slim life as more enjoyable.

Table IV. Parents. Findings of the structural analysis with units of significance, themes and subthemes and examples of meaningful units shown as quotations derived from the text in the naive reading.

Units of meaning—what they say (quotations)	Units of significance—what it speaks	Themes and subthemes
“All our homely food is adjusted to her [child] being obese. But we cannot fully control what she does by herself. We keep telling her not to but she just continues. We have really done everything we could”. “We have done everything at home. We do not have butter, white bread … If she [child] is not motivated … I mean, we cannot lose weight for her”. “I know he [child] buys candy and soft drinks. I tell him not to, but he does not seem to care. He has to want to lose weight I think.”	Believe the food served at home is healthy. Blame the child for unhealthy dieting when by themselves.	Attitudes towards diet Believe the home is an environment where healthy food is prioritised. Blame the child for unhealthy eating habits.
“It happened after he [child] entered puberty. He has become really lazy. He doesn't even want to vacuum clean because it is too much exercise”. “To be honest I don't think she [child] likes to exercise but she does get some. Now she's a member of the gym and last summer she played soccer at the club”. “He [child] cycles sometimes but I think it is because I tell him to do so. He is a member of the gym. But he does not use it”.	Perceive the child as lazy and living a sedentary life. Believe the child has a moderate level of daily, physical exercise. Associate exercise with formalised activities like the sports club or the gym.	Attitudes towardsBlame the child for being lazy. Perceive the child as having a moderate level of exercise. Consider exercise as sport or work out
“He [child] is 15 years old now and should be old enough to make the right decisions.” “You know, I have done everything I could. It is up to her [child] now; she needs to be motivated. She really needs to want to lose weight.” “I think she [child] will mature and start taking some responsibility to her life. I am pretty sure she will grow up in that sense.”	Believe the child is fully supported to engage in a healthier life-style. Perceive the child as lacking motivation and will power to lose weight.	Responsibility and obesity Believe the child needs to make a bigger effort to reduce his/her weight. Cannot support more than already doing.