title: "A little on the heavy side": a qualitative analysis of parents' and grandparents' perceptions of preschoolers' body weights.
abstract: OBJECTIVE
  Parents' difficulties in perceiving children's weight status accurately pose a barrier for family-based obesity interventions; however, the factors underlying weight misinterpretation still need to be identified. This study's objective was to examine parents and grandparents' perceptions of preschoolers' body sizes. Interview questions also explored perceptions of parental responsibility for childhood obesity and appropriate contexts in which to discuss preschoolers' weights.
  
  
  METHODS
  Semistructured interviews, which were videotaped, transcribed and analysed qualitatively.
  
  
  METHODS
  Eugene and the Springfield metropolitan area, Oregon, USA PARTICIPANTS: Families of children aged 3-5 years were recruited in February-May 2011 through advertisements about the study, published in the job seekers' sections of a classified website (Craigslist) and in a local newspaper. 49 participants (22 parents and 27 grandparents, 70% women, 60% with overweight/obesity) from 16 low-income families of children aged 3-5 years (50% girls, 56% with overweight/obesity) were interviewed.
  
  
  RESULTS
  There are important gaps between clinical definitions and lay perceptions of childhood obesity. While parents and grandparents were aware of their preschoolers' growth chart percentiles, these measures did not translate into recognition of children's overweight or obesity. The participants spoke of obesity as a problem that may affect the children in the future, but not at present. Participants identified childhood obesity as being transmitted from one generation to the next, and stigmatised it as resulting from 'lazy' parenting. Parents and grandparents avoided discussing the children's weights with each other and with the children themselves.
  
  
  CONCLUSIONS
  The results suggest that clinicians should clearly communicate with parents and grandparents about the meaning and appearance of obesity in early childhood, as well as counteract the social stigma attached to obesity, in order to improve the effectiveness of family-based interventions to manage obesity in early childhood.
authors.affiliation: Unit for Biocultural Variation and Obesity, Institute of Social and Cultural Anthropology, University of Oxford, Oxford, UK.
authors.forename: Karin
authors.initials: K
authors.lastname: Eli
authors.affiliation: Department of Psychology, University of Oregon, Eugene, USA.
authors.forename: Kyndal
authors.initials: K
authors.lastname: Howell
authors.affiliation: Department of Psychology, University of Oregon, Eugene, USA.
authors.forename: Philip A
authors.initials: PA
authors.lastname: Fisher
authors.affiliation: Unit for Biocultural Variation and Obesity, Institute of Social and Cultural Anthropology, University of Oxford, Oxford, UK Unit of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Paulina
authors.initials: P
authors.lastname: Nowicka
mesh_terms: D000328:Adult; D000368:Aged; D001364:Awareness; D015992:Body Mass Index; D001835:Body Weight; D002675:Child, Preschool; D005190:Family; D006128:Growth; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007182:Income; D007407:Interviews as Topic; D008875:Middle Aged; D009922:Oregon; D010287:Parent-Child Relations; D010290:Parents; D063766:Pediatric Obesity / Q000517:prevention & control / Q000523:psychology; D010465:Perception; D011203:Poverty; D036301:Qualitative Research; D057545:Social Stigma; D055815:Young Adult
keywords: PAEDIATRICS; PRIMARY CARE; PUBLIC HEALTH