title: Severely overweight children and dietary changes--a family perspective.
abstract: OBJECTIVE
  This article is a report on a descriptive qualitative case study of the dietary change experiences of overweight children and their families.
  
  
  BACKGROUND
  Obese children are at risk of experiencing a complicated childhood and becoming obese adults with associated ill health and premature death. The prevalence of obesity among children appears to be rising rapidly. In Europe, prevalence rates for overweight children are 10-40%, and generally this prevalence has tripled during the past 30 years.
  
  
  METHODS
  The study was conducted as a qualitative longitudinal case study on the basis of 2-3 annual interviews with four overweight Danish children, six parents and four siblings from April 2006 to September 2008. Altogether 61 interviews were conducted. In the data analysis process, a thematic, phenomenological approach was used.
  
  
  RESULTS
  The following themes were identified: the reactions and attitudes of children with the sub-themes taking ownership of dietary changes and vulnerability reactions; and the reactions and attitudes of parents with the sub-themes personal acceptance and support, indulgence and protection, setting limits and barriers to successful dietary change. The children were under pressure, showed signs of stigmatization and marginalization, and developed self-protecting strategies. The parents tried to cope to the best of their ability, needed help, but felt rejected by professional key persons and authorities.
  
  
  CONCLUSIONS
  On the basis of the study, it was hypothesised that a prejudice-free, individually accepting and supporting intervention must be provided for each family over time to ensure successful weight loss.
authors.affiliation: Centre of Nursing Research, Viborg, Denmark. vibeke.lorentzen@rm.viborg.dk
authors.forename: Vibeke
authors.initials: V
authors.lastname: Lorentzen
authors.forename: Vicki
authors.initials: V
authors.lastname: Dyeremose
authors.forename: Birte Hedegaard
authors.initials: BH
authors.lastname: Larsen
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D058445:Bullying / Q000523:psychology; D002648:Child; D003718:Denmark / Q000453:epidemiology; D004032:Diet; D018450:Disease Progression; D005192:Family Health; D005195:Family Relations; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology*; D016487:Parenting; D010290:Parents / Q000523:psychology; D015995:Prevalence; D036301:Qualitative Research; D013240:Stereotyping; D061217:Weight Reduction Programs