A free HSE programme designed to empower parents to tackle their child’s increasing weight had such poor take up that it is now under review, at a time when childhood obesity is a major national health concern.
While the families of 95 seven-year-olds, of whom 86 were obese and 9 overweight, were offered monthly dietician-led sessions for six months, just 51 made an appointment with the service.
Of those, only 37 actually showed up. At the end of the six months, just 18 had stayed the course.
An analysis of the programme, published in this month’s Irish Medical Journal (IMJ), highlights how the use of “inappropriate weight-related language” by parents in the presence of children was one of the challenges to sign-up.
“For example when the child was being referred, the parent might have expressed disappointment in front of them that their weight wasn’t lower,” said lead researcher Annemarie Bennett.
Ms Bennett, author of Outcomes of a Community-based Paediatric Weight Management Programme in a Midlands Setting, and assistant professor of dietetics at Trinity College Dublin, said parents sometimes used inappropriate terminology such as “chubby”, “fat”, or “heavy” when talking about their child’s weight or their own weight.
She said this could have a psychological effect on the child who could then become distressed at being referred to the service.
“Parents might think using ‘fat’ is normal, but it is offensive and not helpful in these conversations,” she said.
Getting parents to sign up “without making them feel that their parenting skills are being critiqued” was another challenge, she said.
Also, parents might not recognise obesity as the acute health issue that it is.
A further challenge was getting buy-in from the entire household, so that parents could embed healthier practices in their family’s daily environment.
Families who took part were encouraged to monitor dietary intake, screen time, and exercise.
Cognitive behavioural therapy techniques were used to enhance parental motivation to introduce positive lifestyle changes.
The dieticians running the programme had formal training and it was underpinned by evidence-based best practice.
Yet, at the end of six months, for those who did stay the course, Ms Bennett said they couldn’t say the weight loss in children was “clinically significant”.
She said ultimately the outcome of the programme was “disheartening”.
Now that the programme is under review, the dietetic service will be working with families “to see what it can do to get them to engage more”, Ms Bennett said.
Research shows that at least one in five children in Ireland are overweight or obese. Just 1% of children in the State were classed as obese in 1975; this has risen to 9% among girls and 10% among boys.
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