"Tubby, like a marshmallow" : the lived experiences of children and their parents as participants in a child weight management programme : a thesis presented in partial fulfillment of the requirements for the degree of Master of Arts in Health Psychology at Massey University, Wellington, Aotearoa/New Zealand

Abstract

Global concern regarding the ‘obesity epidemic’ has focused increasingly on children, resulting in numerous child weight management programmes around the Western world. The reality of this ‘epidemic’ is controversial, with large bodies of literature presenting arguments both for and against an urgent need for intervention. Between each side is little common ground, making a cohesive analysis of the extent of the obesity reality difficult. Additionally, there is a paucity of studies that include participants’ experiences. The present study adopted a critical realist ontology in an attempt to bridge the divide between the realist/positivist and relativist/constructionist camps. Further, it aimed to give voice to parents and children through a two-phase exploration of their lived experiences as participants in bodywise, a child weight management programme, based in the Waikato, Aotearoa/New Zealand. In phase one, seven focus groups were undertaken with 22 participants whose children had been part of the bodywise programme, to explore their views on the programme. In phase two, individual interviews were undertaken with three children aged 11 to 16 to explore their experiences of being bodywise. Groups and interviews were audio taped and transcribed verbatim. All data were analysed under an interpretative phenomenological framework (IPA), which provided three superordinate themes, namely sites of struggle, sites of support and sites of success. A key finding was the contrast between the programme’s sole measure of success (the child’s reduced or maintained BMI), and the wide range of successes experienced by participants. The children described success as that which was fun and enjoyable, in contrast to previous studies that found little relationship for children between health behaviours and pleasure. Overall, bodywise was a positive experience for participants regardless of improvements in the child’s BMI. The key metaphor of the experience of bodywise as “special journey” by waka [canoe] was developed from the parents’ talk, and this metaphor is posited as an ideal way to integrate the bodywise experience for all participants. Future research could develop a model based on the waka metaphor model, with an emphasis on fun, enjoyment and active engagement for participants of child weight management programmes.