Perceptions of non-successful families attending a weight-management clinic

Objective: This study seeks to understand family's perceptions of their care at a paediatric weight management service, with a view to informing service improvement.

Design: A qualitative service review conducted via semistructured interviews with parents (n=11) and children (n=3) who attended the clinic. The recruitment was open to all, but those who were not succeeding in their weight-loss goals self-selected to participate. Self-Determination Theory was used as a framework to explore families' experiences of the clinic.

Setting: Recruitment occurred during clinical appointments and interviews were conducted over the phone in the days following the appointments.

Patients: The service sees paediatric patients with a body mass index >99th percentile, with comorbidities or safeguarding concerns.

Interventions: The clinic's service includes appointments typically every 2 months, with a multidisciplinary team including consultant endocrinologists, a dietician, a clinical psychologist, a social worker and a clinical nurse specialist.

Main outcome measures: Families' feedback on the multi-disciplinary team (MDT) clinic, and their perceptions of how improvements could be made.

Results: Families perceive a lack of autonomy, competency and feel a lack of connectivity both in their lives broadly and within their experience at the clinic.

Conclusions: Interventions in families struggling with weight improvements should see the clinical team placing more emphasis on working alongside parents to develop young people's sense of self-determination. Expectations must be set that success originates from changes outside of clinical appointments and that the clinical team is in place to support the family's development of sustainable, self-determined lifestyle habits.