Bothered enough to change? A qualitative investigation of recalled adolescent experiences of obesity

Smith, Emily Rose Elizabeth (2010) Bothered enough to change? A qualitative investigation of recalled adolescent experiences of obesity. PhD thesis, University of Glasgow.

Abstract

Background: Although research suggests that obese children and adolescents are stigmatised, experience victimisation, have poor body image, body dissatisfaction, depression and low self-esteem, these findings have been inconsistent. There is increasing evidence to suggest that body perception rather than actual body size leads to negative psychosocial outcomes with many obese people miss-rating themselves as being ‘normal’ weight; body perception is also the strongest predictor of weight change attempts. The majority of studies in this area have been quantitative; the few previous qualitative studies have either not fully utilised qualitative methods or not focused on adolescents. This study uses qualitative methods, and a unique sampling strategy, to improve understanding of obesity related experiences and reasons for weight change behaviours and success in adolescence.

Methods: 35 semi-structured interviews were conducted between November 2007 and April 2008. Young adult (aged approximately 24) males (17) and females (18) were purposively sub-sampled from The West of Scotland 11 to 16/16+ Study cohort based on measured adolescent obese status (SDS > 1.65 at one or more of the 11 to 16/16+ study age 11, 13 or 15 measurement points). A picture task was used to stimulate discussion about perceptions of health and weight and the interviews continued with discussion of adolescent experiences, weight related behaviours (diet and exercise) and any weight change attempts. Framework analysis was used to organise data and facilitate analysis.

Findings: Initial quantitative secondary analysis of the 11 to 16/16+ data demonstrated that the majority of participants had been worried about both their weight and putting on weight in the future, although this did not translate into slimming behaviour for all.
This study found that body size awareness and related ‘botheredness’ varied greatly and were inconsistently related to each other or to weight. While none of the most obese were among the least aware, some were among the least bothered and vice versa. Botheredness related to body concerns, comparisons with others, clothing, romantic relationships, and for approximately half the sample, victimisation.

Although the majority of participants reported using changes in diet or exercise behaviours in order to try to lose weight at some time, botheredness did not always translate into effective weight change attempts. Participants were categorised as effective slimmers (active and successful weight change attempt), failed slimmers (active but unsuccessful weight change attempt), passive slimmers (weight loss without active weight change attempt), and passive maintainers (had made no attempts to change weight and had no weight loss).

As young adults, 14 were non obese, 14 were obese and 5 were morbidly obese. Those who made successful long lasting weight changes described determination, a greater degree of behaviour change and continued behaviour monitoring. There appeared to be no real pattern to when or why effective changes were made. Age related transitions were often described as being tipping points as well as ‘just being ready’ to change. Those who described sudden unplanned changes were among those who showed the most sustained improvement in weight

Conclusions: Not all those who are obese as adolescents are aware or bothered. Most adolescents are aware of how to lose weight. Being bothered is not enough of a motivator to make long lasting changes – obese individuals need to be ‘ready’ to change regardless of knowledge of health behaviours. More needs to be done to assist individuals in being ready to change, this might include raising; body awareness through periodic body measurements at transition points. Further study of ‘tipping points’ in obese adolescents may aid intervention targeting and design.

• Item Type: Thesis (PhD)
• Qualification Level: Doctoral
• Keywords: qualitative, obesity, adolescent, psychosocial impact, weight change,
• Subjects: R Medicine > R Medicine (General); H Social Sciences > HM Sociology
• Colleges/Schools: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing
• Supervisor's Name: Sweeting, Dr. Helen
• Date of Award: 2010
• Depositing User: Miss Emily Smith
• Unique ID: glathesis:2010-2188
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 27 Oct 2010
• Last Modified: 10 Dec 2012 13:52
• URI: https://theses.gla.ac.uk/id/eprint/2188