Table 5.

Taxonomy of themes, subthemes, and illustrative quotes: How a primary-care provider can be helpful in having a child lose weight.

This table is provided to highlight illustrative quotes that support the key themes and subthemes for the question regarding how a primary-care provider can be helpful in having a child lose weight.

Monitor weight and health risks Use discretion in weight discussions Mother: “When a doctor says to the child, ‘You weigh this much and we need to work on a diet,’ my daughter saying, ‘I’m overweight.’ Then she lookin’ in the mirror—she’s only seven years old. Don’t talk about it in front of her; she’s a child. She should be going to school, playing, not worrying about her weight.” Father: “I think with me having the talk with the doctor about my daughter being overweight, the biggest thing was we talked about it in front of her and she picked up on it. You know, she started thinking about it and making comments. I think the doctor might have more impact telling the parent without telling them in front of the child—step out in the hallway or something, or give me a call.” Discuss weight-related health risks Mother: “My son had to get a diabetes test. [He] is at an age that if you explain to him the effects of being overweight, he understands. The doctor was really concerned. That’s what [my son] needs.” Mother: “The doctors have good resources and good referrals. [My son] actually learned why sugar is a big deal, and cholesterol issues. And that’s something I don’t think about. I need to let him know, ‘This sugar thing {prediabetes} that you’re having is very serious,’ without scaring him.” Do not use scare tactics: Mother: “One of the doctors said that the way I been feeding her is like the same thing as giving her drugs. I said, ‘No, it’s totally different.’ It made me upset.”

Provide specific guidance Healthy diet and lifestyle changes: Mother: “Reinforce a healthy eating lifestyle, and provide a referral to a nutritionist.” Weight-status improvement plan: Mother: “I would talk to her about how much she’s overweight and needs to lose, and how to keep it off.”

Consistent follow-up Continually monitor child’s progress (not just weight): Father: “Develop a strong relationship with them [the child and family]. Then, check up on them—how they are doing, and if they can do it [the weight-management strategy]. Don’t just say, ‘Okay, let’s weigh your child again.’ We know she’s overweight.” Provide encouragement Mother: “We need the consistency of the doctor.” Mother: “Check in. It would be nice just so she could say, ‘Well if I do this, the doctor will be proud of me.’” “You need that coaching, ‘You’re doing a good job.’ You need to hear that as parents.”