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Clinically obese children identified facilitators and barriers to initiating and maintaining the behaviours required for weight loss

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 Q What are the levers (facilitators) and barriers to weight loss from the perspectives of children who are clinically obese?

DESIGN

Qualitative study.

SETTING

Leeds, UK.

PARTICIPANTS

20 clinically obese children (8–14 y, 14 boys), who were attending a National Health Service funded weight loss programme for >3 months, were selected on the basis of availability.

METHODS

All children participated in individual 20 minute interviews, which addressed initial awareness of weight problems, the process of behavioural change, previous attempts to lose weight, reasons for losing weight, and facilitators and barriers to weight loss. As well, 17 children participated in focus groups of 6–8 children that lasted about 40 minutes and addressed issues raised during the interviews. Interviews and focus group discussions were tape recorded, semi-transcribed, and analysed using the 5 stage framework analysis technique (familiarisation, theme identification, indexing, charting, and mapping and interpretation).

MAIN FINDINGS

5 themes were identified. (1) Reasons to change. Bullying was a major reason for change. All children admitted that they had experienced bullying, and some suggested that bullying had become “normal” behaviour: “You hear people calling them …

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