England’s Chief Medical Officer, Dame Sally Davies, has asked why so many people do not view their weight as problematic, despite the high rates of overweight and obesity in this country.
She says children are being put at risk through this so-called normalisation process. Together with my co-author Professor Julia Lawton(University of Edinburgh), I recently published findings that suggest some of the reasons why weight is quite often the elephant in the room where parents and their teenaged children are concerned.
Our study (Attitudes to weight and weight management in the early teenage years: a qualitative study of parental perceptions and views) showed that many parents, particularly mothers, have their own stories to tell about their weight and how they have managed their weight throughout their lives. Weight management, for many parents, was viewed as an irritating and unsuccessful necessity of everyday life.
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Others voiced concerns and some wanted to take action but these concerns were blurred by the physiological changes related to their teenagers’ puberty – how much weight gain is normal during this period of the life course?
Many parents discussed their teenage weight management strategies with us - these were often complex and multi-pronged and kept the ‘teenage’ context in mind in terms of physiological, emotional and social changes associated with this stage of life.
Parents might change the food and drinks they bought, for example, to keep higher fat/sugar foods and drinks under control at home - but some felt that teenagers were their own ‘worst enemies’ as they could buy their own food and drink with friends and were not limited to that provided by parents.
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Some parents gave their children direct advice about weight management but were wary about this approach, given their own negative experiences of controlling weight. Avoiding causing their teenager to develop an eating disorder was also a priority as parents felt young people can become too focused on their body shape, which was viewed as detrimental to wellbeing during the teenage years.
Being responsible for teenaged children and their weight is not easy.
We found in our research that socio-economic status was not linked with parents’ views - normalisation of bodies happened across the social spectrum. One of the reasons for this could be that we all use our own terms of reference to decide what’s normal, rather than terms set by experts and health professionals. If our family, friends and neighbours look similar to us then we consider ourselves to ‘fit in’ with our social group - and this might affect those with a higher, as well as lower socio-economic status. In addition, parents want to be considered as good parents - parents might have to redefine themselves as a ‘bad’ or failing parent if they accept their child is unacceptably large or voice concerns about this. It’s much better to view a child’s body size as normal as it indicates parenting success - at maintaining their weight in a seen-to-be healthy range.
We don’t have all the answers in terms of addressing the obesity problem in teenagers but our findings show that the context in which people look after older children is incredibly complex and fraught with anxieties. Trying to take account of these anxieties and concerns, and helping parents to provide a healthy home, rather than focusing on children’s weight, might go some way to understanding why overweight has started to become normalised in the UK.
The study discussed here involved individual in-depth interviews with 72 young people and their parents. Half of the young people aged 13-15 years were overweight or obese. Half of those interviewed were of low socio-economic status.
Wills, W. J. and Lawton, J. (2014) http://onlinelibrary.wiley.com/enhanced/doi/10.1111/hex.12182/