Treatment for childhood obesity is characterised by high attrition rates and failure to achieve weight maintenance. It is therefore important to develop more effective programmes. The aim of the present qualitative study was to explore the views of parents, children and health trainers to identify issues which can inform the development of more effective programmes.

A qualitative study combining in-depth interviews and focus groups. Participants were selected purposively from current and past attendees.

WATCH-IT, a UK-based community child weight management programme.

Twenty-three families who had previously attended (or were currently attending) WATCH-IT were interviewed. Focus groups with ten trainers explored their views of the intervention.

Parents and children had different goals for involvement, with parents focusing on psychological benefits, while children concentrated on goals relating to weight loss and physical fitness. Parents were found to struggle to provide consistent support to their children and this was exacerbated by family dynamics. The child's commitment to lose weight, support from their family and a good relationship between the child and their trainer were viewed as important keys to successful weight management.

The study will guide the design of existing and future programmes by providing insights into issues that challenge successful engagement. It highlights the possible value of exploring the therapeutic relationship between trainers and participants.

To examine the opinions of physicians in Bahrain regarding their role in obesity control, and to evaluate their knowledge, attitudes and practices towards obesity prevention and management in primary health care.

A cross-sectional survey of physicians in Bahrain. A single-stage cluster sample was used, which included twelve health centres and 107 physicians. Ninety-seven physicians participated in the study with a 90 % response rate. A self-administered questionnaire was used to measure physicians’ knowledge and practices, their perceived role and potential limitations. Correction for design effect and finite population were considered in the analysis.

The majority of physicians in Bahrain (92 %) were aware of the obesity epidemic and 60 % of them felt capable of assuming a major role in obesity control, regardless of their negative views towards the success rates of weight management. Only 36 % agreed that they had effective weight-management practices. They were knowledgeable about weight-loss goals and showed a reasonable level of obesity identification, especially as part of chronic disease care (71 %). Physicians reported a high rate of utilization of various weight-loss strategies, except for pharmacotherapy and surgery. The major barriers identified in patient care included time constraints (91 %), lack of specialty clinics (81 %), absence of guidelines (78 %) and an inadequate number of dietitians (71 %). Sixty-four per cent reported that training in lifestyle counselling and behaviour modification are important requirements.

Physicians in Bahrain showed a reasonable level of interest in participating in obesity prevention and management. It seems that there would be a good opportunity for better practice if physicians were supported with appropriate training and the constraints of their working environment were adequately addressed.

To explore childrens’ and parents’ views and experiences of attending a hospital-based childhood obesity clinic, in order to inform the development of services in primary care.

The prevalence of childhood obesity in the UK is rising. Previous literature identifies the need for long-term, regular follow-up during weight management programmes, and acknowledges the difficulties families face when making lifestyle changes. Primary care has been identified as a possible clinical setting that can meet these needs. However, there is a paucity of evidence to guide the development of such services.

A qualitative interview study was undertaken in a hospital-based childhood obesity clinic in Bristol, England. Short in-depth interviews were held with 21 parents and 11 children attending this clinic. Interviewees were purposefully sampled to ensure interviews were held covering participants of varying age, gender and success in reducing their BMI. The interviews were audiotaped, fully transcribed and analysed thematically.

Families valued the multidisciplinary team approach used in the clinic in terms of the education and support it offered. They enjoyed regular follow-up, reporting that this provided ongoing support and motivation. Families whose children succeeded in BMI reduction appeared more resourceful and tended to embrace ideas for making lifestyle changes. Unsuccessful families, however, found it harder to alter their lifestyle and often met barriers to change. The authors conclude that community obesity clinics will need to provide a multidisciplinary service offering regular support and individualized exercise and dietary advice whilst attempting to address barriers to change.