Abstract
BackgroundThere are high levels of concern about childhood obesity, with obese children being at higher risk of poorer health both in the short and longer terms. Children's attitudes to, and beliefs about, their bodies have also raised concern. Children themselves have a stake in this debate; their perspectives on this issue can inform the ways in which interventions aim to work.This systematic review of qualitative and quantitative research aimed to explore the views of UK children about the meanings of obesity and body size, shape or weight and their own experiences of these issues.MethodsWe conducted sensitive searches of electronic databases and specialist websites, and contacted experts. We included studies published from the start of 1997 which reported the perspectives of UK children aged 4-11 about obesity or body size, shape or weight, and which described key aspects of their methods. Included studies were coded and quality-assessed by two reviewers independently.Findings were synthesised in two analyses: i) an interpretive synthesis of findings from open-ended questions; and ii) an aggregative synthesis of findings from closed questions. We juxtaposed the findings from the two syntheses. The effect of excluding the lowest quality studies was explored. We also consulted young people to explore the credibility of a subset of findings.ResultsWe included 28 studies. Instead of a focus on health, children emphasised the social impact of body size, describing experiences and awareness of abuse and isolation for children with a greater weight. Body size was seen as under the individual's control and children attributed negative characteristics to overweight people. Children actively assessed their own size; many wished their bodies were different and some were anxious about their shape.Reviewers judged that children's engagement and participation in discussion had only rarely been supported in the included studies, and few study findings had depth or breadth.ConclusionsInitiatives need to consider the social aspects of obesity, in particular unhelpful beliefs, attitudes and discriminatory behaviours around body size. Researchers and policy-makers should involve children actively and seek their views on appropriate forms of support around this issue.
Highlights
There are high levels of concern about childhood obesity, with obese children being at higher risk of poorer health both in the short and longer terms
Describing and appraising studies We described the final set of included studies using a standardised classification system developed for public health and health promotion research [14], and another set of questions which built upon frameworks used in previous reviews of the views of children and young people [15]
We looked at each finding from the two syntheses in turn to see if it related to a theme or question in the other synthesis
Summary
There are high levels of concern about childhood obesity, with obese children being at higher risk of poorer health both in the short and longer terms. Children themselves have a stake in this debate; their perspectives on this issue can inform the ways in which interventions aim to work. This systematic review of qualitative and quantitative research aimed to explore the views of UK children about the meanings of obesity and body size, shape or weight and their own experiences of these issues. Like other members of society, have a stake in debates about body size, and their ideas about health and other aspects of their lives are increasingly seen as valid contributions to the development of social policy [7,8]. Children’s own perspectives on obesity and body size, shape and weight can inform the ways in which interventions aim to bring about positive outcomes, there has been no previous attempt to bring studies of children’s perspectives together. An additional review was conducted of studies of young people aged 12-18, as it was considered that perspectives might differ considerably between these two groups (at the time of writing, the report of this separate review is completed but under peer review)
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