Journal of Advanced Nursing (JAN)‘Something Was Missing’: A Qualitative Study of Parents’ Expectations in Weight-Related Health Care for Children

Finnish parents describe weight-related healthcare encounters as passive and unhelpful, with generic lifestyle advice that makes them feel blamed rather than supported despite actively seeking guidance. Study of 18 parents revealed profound disconnect: families received routine growth monitoring and dietary handouts but needed individualized, emotionally safe, multidisciplinary support addressing their actual circumstances.

⚖️ CLINICAL CONSIDERATIONS

• Parents experience stigma by association, feeling judged as inadequate caregivers based solely on child’s weight. This leads to defensive posturing during encounters and rehearsed explanations of healthy choices to prove competence.
• Generic nutrition and activity advice perceived as irrelevant when families already possess knowledge. Parents want family-specific guidance addressing their actual barriers, resources, and daily realities, not standard brochures.
• Parents face impossible tension: protecting child from body image harm and potential disordered eating versus addressing physical health risks. Many fear healthcare discussions will trigger eating disorders or damage self-esteem more than weight itself.
• Lifestyle-focused interventions yield only modest, short-term BMI reductions per existing evidence. Parents identified needs beyond nutrition counseling including mental health support, peer resources, help with family dynamics, and addressing structural barriers like food insecurity.
• Parents described care as passive despite their active help-seeking. This contradicts common assumption that parents are reluctant to engage. Many felt more concerned than clinicians, revealing gap between provider perceptions and parent experiences.

🎯 PRACTICE APPLICATIONS

• Document family’s unique context, resources, concerns, and existing knowledge before offering weight-related guidance
• Ask open-ended questions about family well-being, stressors, daily realities, and what support would actually help, not just diet and exercise compliance
• Avoid discussing child’s weight in child’s presence unless family specifically requests it. Address concerns with parents privately first to establish safety and trust.
• Acknowledge the emotional complexity parents face and create space to discuss their fears about both weight-related health risks and potential psychological harm from intervention
• Refer to mental health, social services, family support, or peer resources when needs exceed clinical scope. Weight management requires multidisciplinary support beyond nursing.

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