Weight- and health-focused conversations in racially/ethnically diverse households with and without a child with overweight/obesity.

Abstract

Studies indicate parent conversations focused on child weight, shape, or size are associated with unhealthy child weight and weight-related behaviors, whereas health-focused conversations are not. Little research has examined what these types of conversations sound like, how parents respond to them, and whether households with or without a child with overweight/obesity approach these conversations differently. This study used qualitative data to identify the weight-and health-focused conversations occurring in racially/ethnically diverse households. Children aged 5-7 years and their families (n ϭ 150) from 6 racial/ethnic groups (i.e., African American, Hispanic, Hmong, Native American, Somali, White) participated in this mixed-methods study. Results showed that parents from households with and without a child with overweight/obesity engaged in similar weight-and health-focused conversations (qualitative themes ϭ focus on growth; health consequences of having overweight/obesity; focus on dietary intake and physical activity; being direct about weight, shape, or size; mixing weight-and health-focused conversations). In addition, findings showed that parents also engaged in different types of weight-and health-focused conversations, depending on whether the household had a child with overweight/obesity (qualitative themes ϭ weight-based teasing; critiquing own weight) or without overweight/obesity (qualitative themes ϭ differences in body shape and size are the norm; focus on modeling rather than talking). Results may be useful for informing public health interventions and for health care providers working with parents regarding weight-and health-focused conversations occurring in home environments of diverse children.

Motivations for engaging in or avoiding conversations about weight: Adolescent and parent perspectives

“…Typically, evidence points to higher levels of parental weight communication with youth who have higher body mass index (BMI) 2,6,7 . However, other evidence indicates that parents engage in weight‐focused conversations with children across diverse body weights and sizes, 8 suggesting that weight communication occurs in families irrespective of weight status.…”

“…Surprisingly little research attention has focused on why parents choose to engage in, or avoid, talking about weight with their children. To date, insights about parental motivations come from primarily qualitative evidence 8,18–22 . For example, findings from interviews with primarily Black/African American parents ( N = 47%, 90% female) found that parents talked to their child(ren) about weight because of a health professional's concern about their child's health; their own parental concerns; or to ‘strengthen their child's skin’ so that their child would not be as upset by being teased about their weight from others 20 .…”

“…8 Parents of children without overweight or obesity reported engaging in weight conversations with their child if a health professional had prompted them to do so, or avoided weight talk because of their own prior negative weight experiences in childhood. 8 Taken together this qualitative evidence suggests that parents may engage in, or avoid, talking to their child about weight for a range of different reasons, some of which may depend on weight-related characteristics of themselves or their child. This body of qualitative work also highlights broader gaps in knowledge.…”

“…To date, insights about parental motivations come from primarily qualitative evidence. 8,[18][19][20][21][22] For example, findings from interviews with primarily Black/African American parents (N = 47%, 90% female) found that parents talked to their child(ren) about weight because of a health professional's concern about their child's health; their own parental concerns; or to 'strengthen their child's skin' so that their child would not be as upset by being teased about their weight from others. 20 Parents who avoided talking about weight did so because they wanted their child(ren) to demonstrate good manners and respect for others (e.g., because of parental views that it is rude to comment on a person's weight), or because of their own previous negative experiences of weight communication from family or friends prompted them to prevent similar experiences for their child.…”

“…Parents of children with overweight or obesity talked about weight because of concerns about their child's weight gain or to teach their child about body weight in a cautionary way (e.g., pointing out the weight gain of other family members). 8 Parents of children without overweight or obesity reported engaging in weight conversations with their child if a health professional had prompted them to do so, or avoided weight talk because of their own prior negative weight experiences in childhood. 8 Taken together this qualitative evidence suggests that parents may engage in, or avoid, talking to their child about weight for a range of different reasons, some of which may depend on weight-related characteristics of themselves or their child.…”