Table 7.

Participants’ emotional reactions to their child's weight.

Emotion	Context	Selected Quotes
Concern	Health problems	I think it was the fact of having issues later on with his health . . . his heart was my main concern and my main reason why we kept on going to appointments.
	Self-esteem	Kids are cruel and when you're getting up to the kids that are in the fourth, fifth grade they're smart, and if they know what this is and it's being circulated around then there's a problem.
	Provider sensitivity	Don't single them out. Don't make him feel like he has a problem, a big – a disease – you know?
Guilt	Parent's role	You take most of the blame because you're like I'm the mother and I can't believe that I didn't pick healthy choices.
		Did I do enough? You beat yourself up and the kids notice that too.
Fear	Child's reaction	[My son] heard things, not necessarily what the pediatrician said, but what he took away from it was – you're doing everything wrong – and his instant reaction was to just stop eating, which scared me.
	Scary words	[Extremely obese is] scary, yeah that's scary.
Upset	Offensive words	I hate [the word obese], I do.
	Provider response	The only time [my daughter's pediatrician] talks about [weight] is on her physical when she shows me the growth on charts, compares age and weight, the BMIs and all that.
	Receipt of letter	I've gotten something like this [letter] . . . I was kind of upset ‘cause I said, ‘Who are these people?’ I take my kids to the doctor so I already know where they stand.
	School's role	This should not be coming from the school system.
Rationalization	Muscle mass	Because a kid with muscle is not obese.
	Heredity	Some people just don't thin out like that or some people just stay big or they have bigger bones.
	Obesity prevalence	The doctor should not be critical and they should be understanding because it's a world problem that we have, it's not just us here.
	Medical conditions	Let's think about something called thyroids, different metabolism inside the body, which might multiply their growth.
Skepticism	Validity of BMI	They're not doing the water test, they're not doing the pinching and all that.
Acceptance	Focus on health	I think instead of saying, ‘We're going to give you a referral to the obesity clinic,’ they should say, ‘We're going to give you a referral to someone that's going to help you eat healthier and live a healthier life and show you ways to be more active.’
	Provider feedback	I don't think I ever had any negative, any kind of feedback is good feedback . . . just telling what kinds of foods to eat, the portion size, how often to eat, what time not to eat at.
	School's role	This is very positive, and I think everybody should get it and get screened.
	Information in letter	[The letter] only encouraged me to move. I didn't have a problem with it.