Bringing it all back home: families with children with obesity

Despite the fact that there is an acknowledged ‘lack of evidence of effectiveness’ that ‘familybased
health promotion interventions impact on obesity and overweight’ (National Audit Office,
Healthcare Commission and Audit Commission, 2006, NICE 2006a) the recently released
NICE guidelines emphasise that ‘All actions aimed at preventing excess weight gain and
improving diet (including reducing energy intake) and activity levels in children and young
people should actively involve parents and carers’ (NICE 2006 p.20). Parents are offered
advice to ‘help children establish healthy behaviours and maintain or work towards a healthy
weight’ (NICE 2006 p16): the child becomes a passive consumer of interventions directed at
the family – predominantly at parents. We suggest that such policy is based on a restricted
understanding of family that does not take fully into account the complexity of family
relationships and dynamics. We illustrate this in relation to findings from two qualitative
research studies focusing on obesity and a Leverhulme funded project, Making Healthy
Families, that is currently investigating the intersections between food and family practices.
This latter project forms part of larger programme, Changing Families, Changing Food, which is
being conducted at the University of Sheffield.
Much of the empirical data for this paper is taken from the ‘How is it for you’ project which
explored, with children and young people, their experiences of being obese and from
preliminary findings from an ongoing study which focuses on the experiences of parents of
children with obesity. Data were generated through focus group discussions and individual
interviews with young people between the ages of 10 and 17 who were attending, or had
attended a community based obesity intervention programme and with the parents of young
people associated with the programme. Young people’s and parents’ understandings of obesity
and relations between familial adults and children with obesity are explored through three
theoretical themes: explanatory discourses; family relationships and practices and; family
eating environments. Family members, we argue, adopt varied subject positions that
sometimes defy traditional parent/child models that position children as the passive recipients of parental influence.