This study examined issues faced by parents of overweight and obese adolescents and advice for other parents in similar situations. Issues raised by parents included: difficulties encountered in effectively communicating with their adolescent about weight-related topics, perceived inability to control adolescent’s decisions about eating and physical activity, concern for adolescent’s physical and mental well being, and feelings of personal responsibility for adolescent’s weight issues (Table 1). Parental advice for helping overweight adolescents included having a healthy home environment, modeling healthy behaviors, and providing encouragement and support to adolescents for positive behavior changes (Table 2).
Interestingly, many of the issues participants identified are similar to issues faced by parents of adolescents in general. For instance, communicating effectively about sensitive topics like alcohol and drug use is one struggle many parents face.32
Parents interviewed for this study may struggle with those same issues as well, but were additionally concerned about how to discuss weight issues with their adolescent. Most parents, whether their adolescent had lost weight or not, were unsure of when to bring up the subject of weight and furthermore, how far to push the subject once the subject was brought up with their adolescent. These findings corroborate findings by Pagnini and colleagues about the challenges in having productive, helpful, and non-judgmental conversations about weight with their children. 33
Parental advice for other parents of overweight adolescents appears to parallel and address the issues faced in parenting overweight adolescents. For instance, advice for parents to establish a healthy home environment and model healthy behaviors could be helpful in addressing feelings of responsibility for adolescent’s weight struggles and inability to control all of the adolescent’s decisions related to eating and activity. If parents have healthy foods available at home and are modeling healthy eating and exercise habits, they may be less likely to feel their own actions and lifestyle at home are to blame for their adolescent’s weight issues. Additionally, research shows that maternal concern for healthy eating is associated with both maternal and adolescent fruit and vegetable consumption.24
Similarly, parents may feel more confident in an adolescent’s decision-making ability about healthy eating and activity if they have done what they felt was possible in their own home and modeled healthy behaviors. Results from the current study are also similar to those of Booth and colleagues who interviewed parents of overweight youth and reported concerns by parents regarding the amount of control they had over weight related decisions their children make. 34
Parents felt they did have control over what foods were in the home. Data from the current study provide further support for quantitative findings showing the importance of parental modeling and home availability of healthy foods such as fruits and vegetables in adolescent’s intake 16,18
as well as qualitative studies with adolescents citing these factors as contributors to their food choices.17
Parental provision of healthy meals and modeling of healthy behaviors could assist their adolescent in engaging in these behaviors. The family meal is a time when parents have the opportunity to model healthy eating behaviors, but the frequency of family meals decreases throughout adolescence.27,28
In addition to the family meal providing an opportunity to serve as a role model, this is also a time for parents to communicate with their adolescent as well as provide support for positive behavior changes. 15
The current study provides initial data that support for healthy eating and physical activity behaviors for adolescents could come in the form of both “doing” and “talking”. Parents can think of these two categories as methods for influencing their adolescent’s weight. In terms of “doing”, parents can support their adolescent’s physical activity level by engaging in shared activities such as going on evening walks together, playing active games together, planning active family vacations, by watching their children perform in various sports activities, and by providing transportation to local recreational facilities. Parents can support their adolescent in eating more healthfully by providing a healthy home environment and modeling healthy eating behaviors.
In terms of “talking” about adopting healthier eating and physical activity behaviors, it is important for parents to remember that their adolescent could have a negative emotional response (i.e. sad or angry) when questioned about their weight. In the current study, and other studies,33,34
parents were aware of the psychosocial effects of being overweight. Therefore exploring other methods of addressing weight issues besides just focusing on weight loss may be needed when working with adolescents, such as being fit and physically active, or eating for health. Practitioners can help facilitate positive change within the home environment for the whole family instead of only focusing on the adolescent. In addition, given the issues about communication it is important that practitioners recognize these challenges and work to support and help both parents and adolescents. The current study has several strengths and limitations that deserve notation. This is the only study that we are aware of that explored parenting issues from the perspective of parents of overweight adolescents.
Through the use of one-on-one interviews, rich, in-depth information was gathered from parents about the specific issues they face on a day to day basis in parenting overweight adolescents. The interview format also allowed participants to expand upon responses, which created a greater understanding of parental issues. Limitations of the study include a small, self-selected sample size with limited diversity in gender and ethnicity that does not fully represent all population groups. Additionally, some of the adolescents in this study had lost some weight, however, the interviews did not reveal any differences in parental responses between parents of adolescents who lost weight and those who did not. Further research should expand on these findings with larger, more diverse populations.