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Table 2 Theme 1: Comments regarding motivation to enrol in the program

From: Why do parents enrol in a childhood obesity management program?: a qualitative study with parents of overweight and obese children

Sub-theme 1: Parents were aware of children’s weight issue for a long time.
P7: ‘I have been watching it [weight] for a while, since 2010’
P8: ‘I watched the way he looked for a while’
P10: ‘She’s always been bigger then peers the same age…I’ve been keeping an eye on weight progression and in the last couple of years it increased a lot….she looked chubby’
P12: ‘She’s been overweight since 2–3 years old… she’s always has been at the higher range of overweight and lower range of obese’
P15: ‘It’s always been on the higher end [BMI]’
P16: ‘I wasn’t surprised that he’s overweight because the weight and height has been higher for a while now for age…I got worried when it was flagged by the paediatrician’
P17: ‘She (daughter) is getting older and weight is getting higher and higher’
P18: ‘I was suspected it (child’s overweight) for a while but didn’t want to believe it’
P19: ‘I was concerned for at least 2 years’
P20: ‘I knew for a long time, I was aware since the beginning’
Sub-theme 2: Visual assessment of children’s weight status (preference for using subjective rather than objective weight assessment methods).
P1: ‘Weighing [on scales] is not something we do regularly at home…just by looking at her you can see that she is overweight…has a stomach like a pregnant woman’
P8: ‘He’s bigger than average, in comparison to other kids at school…I didn’t put him on scales, I don’t like doing it’
P9: ‘It’s obvious that he’s overweight…just by looking at him…I don’t weigh him but I can see…he’s bigger and taller than others but the body shape is altered…he has man boobs’
P10: ‘I didn’t want to check weight on scales not to emphasise the numbers to him and make a big deal about it’
P12: ‘I never checked weight but you could just see that she’s bigger, especially around the middle’
P13: ‘He’s not proportionally overweight, he doesn’t look overweight…and he is not unfit’
P14: ‘Looks a little chubby’
P15: ‘She is not fat, doesn’t have a big belly like the other kids…when you look at her she doesn’t look overweight’
P16: ‘I noticed that the clothes were getting tighter, she preferred to wear pants with elastic waist rather than jeans…in dancing clothes she was really sucking in her tummy and in comparison to other girls she looks bigger…I never used scales but I noticed that I was struggling to pick her up when giving her a hug’
Sub-theme 3: Children are aware of their weight issue.
P4: ‘He notices that he’s bigger than other kids…[he] gets bullied and called fat and lazy’
P6: ‘He realised himself that he is bigger, gets tired easily and asked me why he is slow and fat’
P7: ‘She [daughter] came in crying and said to me [mother] ‘why am I fat…I am fat”
P8: ‘He was aware of his own weight, wanted trendy clothes as the other kids but there was no size for him’
P10: ‘She feels different to other children, told me that she doesn’t want to do sport anymore, gets tired easily, complained that nobody wanted her on their team’
P11: ‘She feels bad about herself and own body…she said ‘I hate myself, I hate my body, just kill me’
P14: ‘He often complains about his red hair, freckles, his tummy, that he is slow and useless. He really brings himself down…he feels that he is just not good enough and weight is just one more things added to it all’
P16: ‘In bath he sometimes tells me: ‘Mummy look at layers on my tummy”
P17: ‘Pretty clothes at the shops don’t fit her…because she has a big tummy…she gets upset because she looks awful’
Sub-theme 4: Parental concerns about addressing children’s weight and joining PEACH.
P1: ‘I don’t want her to feel bad about weight’
P4: ‘I spoke to him [about starting PEACH], he was very hesitant…he was worried that it may be another situation when he will be told that he’s fat, eats too much’
P6: 'I was worried what he may think that I think of him, I worried that he may think that I see him as fat'
P8: ‘When I spoke to him [child] about it [starting PEACH] he started crying and said: they will tell me that I’m fat’.
P17: ‘She [daughter] seems to think that skinny is healthy too…media shows only skinny people…children may think that skinny is good, is what the world wants…She [daughter] asked me not to tell anyone at school [about attending PEACH]…she doesn’t want to have attention drawn to her weight’