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Perceptions of non-successful families attending a weight-management clinic
  1. Jennifer S Cox1,
  2. Aidan J Searle1,
  3. Elanor C Hinton1,
  4. Dinesh Giri2,3,
  5. Julian P H Shield1
  1. 1 National Institute for Health Research Bristol Biomedical Research Centre, Nutrition Theme, University of Bristol, Bristol, UK
  2. 2 Department of Paediatric Endocrinology, Bristol Royal Hospital for Children, Bristol, UK
  3. 3 Department of Translational Health Sciences, University of Bristol, Bristol, UK
  1. Correspondence to Jennifer S Cox, National Institute for Health Research Bristol Biomedical Research Centre, Nutrition Theme, University of Bristol, Bristol BS8 1TL, UK; jennifer.cox{at}


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.

  • adolescent health
  • endocrinology
  • obesity
  • qualitative research

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  • Collaborators Claire Semple, Rhian Augustus, Shelley Easter, Melanie Wenn.

  • Contributors All named authors met ICMJE recommendations for authorship, JC was the lead author and involved in every step of the work. AJS conceptualised the work, contributed to the analysis, drafting and revisions. ECH contributed to the conceptualisation and design of the work, interpreting the data and the drafting of the document. DG contributed to the acquisition of the data and drafted the work and JPHS contributed at every stage of the work.

  • Funding This work was supported by the GW4 MRC. This review was supported by researchers funded by the NIHR Bristol Biomedical Research Centre, Nutrition theme.

  • Disclaimer The views expressed in this publication are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.

  • Competing interests The lead clinicians (JPHS and DG) responsible for delivering the clinic are authors on the paper due to their contributions in the design of the review and the facilitation of the data collection. In order to preserve integrity, JPHS and DG were not involved with the analysis or interpretation of the dataset. JPHS and DG have not influenced or amended the Result section, but have contributed clinical expertise to the validity of the recommendations.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request. Deidentified participant data can be made available on request. Please contact the lead researcher on with any requests or for more information.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.