How family interactions about lifestyle changes affect adolescents' possibilities for maintaining weight loss after a weight-loss intervention: a longitudinal qualitative interview study.
OBJECTIVE
This study aims to examine how family interactions related to lifestyle changes influence adolescents' potential for maintaining weight loss after participating in a weight-loss treatment programme.


BACKGROUND
Obesity among adolescents is a large and complex health problem worldwide. Family support is crucial if adolescents are to benefit from weight-loss intervention.


METHODS
Qualitative research interviews with families who participated in a weight-loss programme.


METHODS
The sample consisted of 10 families selected among participants in a 1-year multidisciplinary family-based weight-loss programme. Three rounds of semi-structured interviews stretching over 5 years (2010-2015) were transcribed verbatim, then analyzed using Kvale and Brinkmann's framework for working with qualitative research interviews.


RESULTS
Five years after the intervention ended, we found that a family's interactions were a key factor in how the family handled challenges involved in changing its diet and increasing physical activity and that daily activities in modern families influenced their interaction, as activities demanded so much of the family that it was difficult to sustain the lifestyle changes necessary for the adolescent to maintain achieved weight loss. Supporting the adolescent was far more difficult than families expected; more time-consuming and also a cause of family conflicts. Siblings who did not need to lose weight played a major, but overlooked, role.


CONCLUSIONS
The family's interactions and its handling of lifestyle changes were important to the adolescent's maintained weight loss. It is fundamental that the entire family is supportive, regardless of family structure and these issues ought to be addressed in future interventions.
Department of Paediatrics, Regional Hospital Viborg, Denmark.|The Centre for Research in Clinical Nursing, Denmark.|Section for Nursing, Department of Public Health, Aarhus University, Denmark.
Marianne
http://orcid.org/0000-0002-9803-553X
M
Eg
Section for Nursing, Department of Public Health, Aarhus University, Denmark.
Kirsten
K
Frederiksen
Section for Nursing, Department of Public Health, Aarhus University, Denmark.
Marianne
M
Vamosi
Section for Nursing, Department of Public Health, Aarhus University, Denmark.|Centre for Nursing Research - Viborg, Denmark.|School of Nursing and Midwifery, Faculty of Health, Deakin University, Australia.
Vibeke
V
Lorentzen
D000293:Adolescent; D002648:Child; D005195:Family Relations; D005247:Feeding Behavior; D005260:Female; D000070497:Healthy Lifestyle; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010349:Patient Compliance; D063766:Pediatric Obesity / Q000628:therapy*; D012944:Social Support; D015431:Weight Loss / Q000502:physiology*; D061217:Weight Reduction Programs
adolescents; family interactions; interviews; long-term study; nursing; obesity; overweight; siblings; weight loss; weight-loss treatment