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Table 2 The structure of the main themes, their sub-themes and the codes that make up the sub-themes

From: Is children’s weight a public health or a private family issue? A qualitative analysis of online discussion about National Child Measurement Programme feedback in England

Main theme



1) Sources of legitimate feedback

‘Parents know what is best for their child and do not need outside input’

Result is wrong (child is not overweight)


External input in inappropriate/unnecessary

Feelings (shock, fury, upset, angry, annoyed)

Parenting failure, perceiving being told off

More factors need to be considered (family background, lifestyle, puberty)

Interventions should target other aspects of children’s life (school, neighbourhood)

Parent identity

Some parents need a reminder

Feedback letter is gentle/friendly reminder

Overweight is perceived as the new normal in children, it became harder to notice a weight problem

Letter contains useful advice and weight loss programmes

Parents can be blind/biased in relation to their child and need an objective opinion

It is better to intervene early (in childhood) than struggling with weight in adulthood

The initial emotional harm to children is less than the overall harm of living excess weight

BMI is a reliable tool for weight, appropriate for population level

Health or educational professional identity

2) Intrusion versus intervention

‘Nanny state’

Distrust in government collecting this data


The state intrudes into family life

Nanny state (the state telling people what to do)

Concerns about anonymity and confidentiality of children’s data

The measurements should not be done in schools (perception of schools being behind the programme)

Evidence based policy …how can that be wrong?’

The NHS needs statistical data to plan services locally and nationally

Treating health problems due to excess weight costs the NHS money

Participating is important for everyone for the sample to be representative

Overweight in childhood can lead to overweight and health problems in adulthood

Data collecting does not link to individual children, but is used for population statistics

3) Weight obsession versus weight discussion

Unhealthy weight obsession

Over-emphasising the importance of weight is wrong


Measurements lead to discussing weight and upset children

Discussing weight will lead to 'complexes' or even eating disorders

BMI charts are one-size-fits-all and idealise a slim body shape

Emotional harm on children is worse than being overweight

Parents will deal with real problems when they arise (i.e. childhood overweight is not real problem)

Parents’ own history of childhood weight complexes and/or eating disorders

Healthy weight discussion

Weight is natural part of life and discussing it will not do harm

Parents themselves decide whether they conduct healthy discussion about weight

Weight is not important in relation to an ideal appearance but in relation to health

Measurements are done sensitively and results not discussed with children to avoid harm

The BMI chart allows for a wide range of normal, and is not trying to fit different shapes into the same size