Our aim for this project is to create and test the impact of evidence-based guidance to help parents to have the most positive conversations they can with children about weight.

Little advice is currently available to parents to help them decide whether or how to talk to their child about their weight, or to guide healthcare professionals on how to support parents when raising the topic. This project is designed to fill that gap.

Progress

Our guidance is based on research evidence, developed in collaboration with experts from a range of professional backgrounds, along with parents.

Development is now complete, and the document has been published with support from the British Dietetic Association. You can download and read the document here. The content has been found to be acceptable with parents, school nurses and children themselves.

Our current aims are to identify sources of funding to run a trial to assess the impact of the guidance on:

• parents (in terms of their confidence in talking about weight with children and health professionals, and reducing potential anxiety and distress when a child is above a healthy weight)
• health professionals (in terms of their willingness and confidence in talking to parents about children’s healthy weight)
• children’s wellbeing and body satisfaction

In parallel, and in the context of both rising levels of childhood obesity and children’s weight dissatisfaction and unhealthy weight control behaviours, we are exploring how implementation of the guidance could support the promotion of a healthy childhood weight while also promoting wellbeing.

Team members

• Professor Fiona Gillison
• Dr Tania Griffin
• Fran Baber

Partners

• Dr Billy Twomey (MSc Sport & Exercise Medicine)
• Dr Lis Grey, (University of Bristol)
• Professor Angel Chater, (UCL/University of Bedfordshire)
• Dr Lou Atkinson, (University of Warwick)
• Alison Gahagan (Office for Health Improvement and Disparities)

Phase 1: Development of evidence-based guidelines for parents on talking to children about weight

This phase has been completed

The initial stage of the project involved collecting and collating existing research evidence exploring the different types of weight and health communication between parents and children on children’s wellbeing. Where evidence was not available, we generated new data through primary research, stakeholder engagement activities, and drawing on evidence in related settings to (e.g., parent-child communication about other sensitive topics). This phase resulted in two systematic reviews (Gillison et al., 2016, and Grey et al., 2022), a review of available guidance available in other countries and sources, and interviews with children and parents.

The insights of this work were combined, to provide theory and evidence-informed advice for parents on both what to say, and how to say it. 28 experts from outside the research team - including members of the public, school nurses, public health specialists, GPs, dieticians, clinical psychologists, civil servants, people working for eating disorder charities and academics - worked with us on refining the guidance into a final format. This guidance was then piloted through interviews with parents and school nurses as part of the National Child Measurement programme in summer 2021, and with a few adjustments found to be acceptable and useful to parents and health care practitioners.

Links to further information:

• Read a published report on the development of the guidance document
• Read a published pilot study of the guidance document’s use with parents and school nurses
• Download our guidance document (currently in PDF format)

Phase 2: Research to test the impact of the guidance in practice

This phase is in progress

We are in the process of conducting research about the acceptability and feasibility of implementing the guidance in different settings.

Our current progress is:

• A version of the guidance was shared for use with nine local authorities who were taking part in a pilot project with the Office of Health Improvement and Disparities (OHID) different project during the 2021/22 school year.
• A qualitative study is underway to explore the acceptability and perceived utility of the guidance among GPs in Ireland. This project forms part of a master’s research project in Sport and Exercise Medicine at the University of Bath.
  
• We are currently running focus groups in schools in England, to explore children’s views on the ways of talking about weight included in the guidance.

Phase 3: Implementation

This phase is in progress

We are liaising with national public health bodies, including the Office of Health Improvement and Disparities (OHID) and Public Health Scotland, to identify routes and opportunities to make the guidance openly available for use by parents and people working with families around children’s healthy weight. It may be particularly relevant for inclusion to support parents when they are made aware of children’s weight being above the healthy range, for example as part of national weighing and measuring programmes.

The guidance is endorsed by the British Dietetic Association. We are seeking funding to explore different delivery formats to make the guidance more accessible.

Links to further information:

• E-learning tool for health care professionals and others working with families around children’s healthy weight