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.