“Weighing is annoying” – Weighing of higher-weight children between discomfort, discrimination, and potential for change

Abstract

Objective

Weighing is part of medical care. Still, little is known about the relationship between weight stigma, discriminatory behavior by health professionals, and the weighing situation of higher-weight children. This study explored the weighing situation of higher-weight children with the aim of identifying important setting factors and discriminatory behaviors, thus providing opportunities for a weight-sensitive approach.

Methods

Qualitative study-arm within a mixed methods design in 4 rehabilitation centers in Germany specialized in outpatient rehabilitation programs for children diagnosed with “obesity”. Semi-structured telephone interviews with 19 health professionals and 19 parents, and 6 semi-structured focus groups with a total of 35 children were conducted. Data analysis followed the framework analysis.

Results

Several themes surrounding the weighing situation were highlighted, including uncomfortable feelings, and the risk of developing eating disorders. The number of people in attendance, being forced to undress, or the gender and weight of the doctor were mentioned as influencing setting factors. Discriminatory behavior by health professionals could cause discomfort and avoidance of the healthcare system. Several children suggested having fewer people around, deciding on who weighs them, and keeping their clothes on. Children asked for sensitive responses after the weighing and to decide when the weighing takes place.

Conclusions

Weighing is highly sensitive, with a great need for awareness and a weight-sensitive approach. These findings underline the requirement for training of health professionals in weight-sensitive assessment and treatment.

Practical implications

These findings provide important instructions for clinicians on weight-sensitive weighing and offer suggestions to improve the practice of weighing.