"It's not like a fat camp" - A focus group study of adolescents' experiences on group-based obesity treatment.
BACKGROUND
The health burden related to obesity is rising among children and adolescents along with the general population worldwide. For the individual as well as the society this trend is alarming. Several factors are driving the trend, and the solution seems to be multifaceted because long-lasting treatment alternatives are lacking. This study aims to explore adolescents' and young adults' motivation for attending group-based obesity treatment and social and environmental factors that can facilitate or hinder lifestyle change.


METHODS
In this study, we arranged three focus groups with 17 participants from different obesity treatment programs in the west and south of Norway. The content in these programs differed, but they all used Motivational Interviewing as a teaching method. We conducted a data-driven analysis using systematic text condensation. Self-determination theory has been used as an explanatory framework.


RESULTS
We identified four major themes: 1) motivation, 2) body experience and self-image, 3) relationships and sense of belonging, and 4) the road ahead. Many of the participants expressed external motivation to participate but experienced increasing inner motivation and enjoyment during the treatment. Several participants reported negative experiences related to being obese and appreciated group affiliation and sharing experiences with other participants.


CONCLUSIONS
Motivation may shift during a lifestyle course. Facilitating factors include achieving and experiencing positive outcomes as well as gaining autonomy support from other course participants and friends. Obstacles to change were a widespread obesogenic environment as well as feelings of guilt, little trust in personal achievements and non-supporting friends.
Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; annahulda.engstrom@gmail.com.
Anna
A
Engström
Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Eirik
E
Abildsnes
Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Thomas
T
Mildestvedt
D000293:Adolescent; D000328:Adult; D001828:Body Image; D005260:Female; D017144:Focus Groups; D006126:Group Processes; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D009042:Motivation; D062405:Motivational Interviewing; D009664:Norway; D009765:Obesity / Q000523:psychology* / Q000628:therapy; D026684:Personal Autonomy; D036301:Qualitative Research; D012649:Self Concept; D012944:Social Support; D015431:Weight Loss; D055815:Young Adult
Weight management; adolescents; lifestyle; motivation; self-determination theory