"It's a balance of just getting things right": mothers' views about pre-school childhood obesity and obesity prevention in Scotland

Flora Douglas, Julia Clark, Leone Craig, Jonina Campbell, Geraldine McNeill

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BACKGROUND: The high prevalence of childhood obesity is a concern for policy makers and health professionals, leading to a focus on early prevention. The beliefs and perspectives of parents about early childhood obesity, and their views and opinions about the need for weight management interventions for this age group are poorly understood.

METHODS: A formative qualitative focus group study with parents of pre-school children took place in eight community-based locations throughout North-East Scotland to explore their ideas about the causes of early childhood obesity, personal experiences of effective weight management strategies, and views about the format and content of a possible child-orientated weight management programme. Study participants were recruited via pre-school nurseries.

RESULTS: Thirty-four mothers (median age 37 years) took part in the study, but only two believed their child had a weight problem. Participants (who focussed primarily on dietary issues) expressed a strong sense of personal responsibility to 'get the balance right' regarding their child's weight, and were generally resistant to the idea of attending a weight management programme aimed at very young children. At the same time, they described a range of challenges to their weight management intentions. These included dealing with intrinsic uncertainties such as knowing when to stop 'demand feeding' for weight gain, and judging appropriate portion sizes - for themselves and their children. In addition they faced a range of extrinsic challenges associated with complex family life, i.e. catering to differing family members dietary needs, food preferences, practices and values, and keeping their 'family food rules' (associated with weight management) when tired or pressed for time.

CONCLUSIONS: The findings have important implications for health professionals and policy makers wishing to engage with parents on this issue, or who are currently developing 'family-centred' early childhood weight management interventions. The challenge lies in the fact that mothers believe themselves to be the primary (and capable) agents of obesity prevention in the early years - but, who are at the same time, attempting to deal with many mixed and conflicting messages and pressures emanating from their social and cultural environments that may be undermining their weight management intentions.

Original languageEnglish
Article number1009
JournalBMC Public Health
Publication statusPublished - 27 Sept 2014

Bibliographical note

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

This study was funded by NHS Grampian. FD, LC, JC, and GMcN receive personal support from the RESAS programme of the Scottish Government Nutrition and Health. We would also like to thank Caroline Comerford of NHS Grampian and other members of the research steering group for their advice during the study; the parents for their time and input; the nursery school staff for distributing study packs for parents; Andrea Gilmartin for organising the focus groups and Dr Sandra Carlisle for the helpful comments on earlier drafts of the manuscript.


  • young children
  • obesity
  • mother's views
  • weight management
  • qualitative research
  • Scotland


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