OBESIDADE INFANTIL E ENFRENTAMENTO FAMILIAR acesso 08-02

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ORIGINAL ARTICLE 
41 
REPENF – Rev Par Enferm. 2019; 2(1):41-50. Oliveira AC, Ribeiro DM, Camargo EM, 
Soares LG, Abreu AS, Soares LG. 
 
 CHILD OBESITY AND FAMILY STRUGGLE 
 
 OBESIDADE INFANTIL E ENFRENTAMENTO FAMILIAR 
 
 OBESIDAD INFANTIL Y ENFRENTAMIENTO FAMILIAR 
 
Amanda Cristina Oliveira1 
Débora Maria Ribeiro2 
Ediane Machado Camargo3 
Letícia Gramazio Soares4 
Isabella Schroeder Abreu5 
Larissa Gramazio Soares6 
 
ABSTRACT 
 
Objective: To understand how families of obese children deal with childhood obesity. 
Methods: descriptive, exploratory, qualitative study. Data collection took place from 
January to June 2017, through semi-structured interviews, in the homes of children 
followed-up at the Nutrition Clinic School of the Centro-Oeste State University, 
Guarapuava, Paraná. The data analysis was based on the technique of Content Analysis, 
thematic modality. Results: seven mothers and one grandfather of obese children 
participated in the study. From the data emerged two thematic categories: “The influence 
of the family on healthy habits” and “Childhood obesity and social prejudice”. Final 
considerations: dealing with childhood obesity by families requires acknowledgment of 
the critical role they play developing healthy habits in childhood. In addition, health 
education programs that target changes in eating patterns and stimulate physical activity 
are important for improving attention to the obese child’s family as they reduce weight-
related harms and injuries. 
Descriptors: Familiy Relations; Pediatric Obesity; Pediatric Nursing. 
 
 
 
1 Nurse. Resident in Nursing in the Hospital Service/Emergency and Urgency/Nursing Program of the State 
University of Ponta Grossa (UEPG). E-mail: amandagruskoski@hotmail.com 
2 Nurse. Resident in Nursing in the Hospital Service/Emergency and Urgency/Nursing Program of the Federal 
University of Paraná (UFPR). E-mail: ribeirodeboramaria@gmail.com 
3 Nurse. Guarapuava, Paraná, Brazil; E-mail: edicamargo1253@gmail.com 
4 Doctorate in Nursing. Adjunct A Professor of the Nursing Department, Centro-Oeste State University 
(Unicentro). Guarapuava, Paraná, Brazil; E-mail: leticiagramazio13@gmail.com 
5 Doctorate in Nursing. Adjunct B Professor of the Nursing Department, Centro-Oeste State University 
(Unicentro). Guarapuava, Paraná, Brazil; E-mail: i_enf@yahoo.com.br 
6 Doctorate student in Nursing, Federal State University of Paraná (UFPR). Professor of the Nursing Department, 
State University of Unicentro. Guarapuava, Paraná, Brazil; E-mail: lari_gramazio@hotmail.com 
 
Corresponding author: Leticia Gramazio Soares. Address: Rua Getúlio Vargas, 28, Trianon. CEP 85012-270, 
Guarapuava, PR, Brasil. E-mail: leticiagramazio13@gmail.com 
mailto:amandagruskoski@hotmail.com
mailto:ribeirodeboramaria@gmail.com
mailto:edicamargo1253@gmail.com
mailto:leticiagramazio13@gmail.com
mailto:i_enf@yahoo.com.br
mailto:lari_gramazio@hotmail.com
mailto:leticiagramazio13@gmail.com
 
 
 
 Child obesity and family struggle 
 
 
 
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REPENF – Rev Par Enferm. 2019; 2(1):41-50. Oliveira AC, Ribeiro DM, Camargo EM, 
Soares LG, Abreu AS, Soares LG. 
RESUMO 
 
Objetivo: compreender como famílias de crianças obesas lidam com a obesidade infantil. 
Métodos: estudo descritivo, exploratório, de abordagem qualitativa. Os dados foram coletados 
no período de janeiro a junho de 2017, por meio de entrevistas semiestruturadas, nos 
domicílios das crianças atendidas na Clínica Escola de Nutrição da Universidade Estadual do 
Centro-Oeste, em Guarapuava, Paraná. A análise dos dados fundamentou-se na técnica de 
Análise de Conteúdo, modalidade temática. Resultados: participaram do estudo sete mães e 
um avô de crianças com obesidade. Dos dados emergiram duas categorias temáticas: “A 
influência da família nos hábitos saudáveis” e “Obesidade infantil e preconceito social”. 
Considerações finais: o enfrentamento da obesidade infantil pelas famílias requer o 
reconhecimento do papel decisivo que desempenham na formação de hábitos saudáveis 
durante a infância. Além disso, programas de educação em saúde que almejem mudanças de 
padrões alimentares e estimulem a prática de atividades físicas são importantes para melhorar 
a atenção à família da criança obesa, pois permitem reduzir danos e agravos provocados pelo 
excesso de peso. 
Descritores: Relações Familiares; Obesidade Infantil; Enfermagem Pediátrica. 
 
RESUMEN 
 
Objetivo: comprender cómo las familias de los niños obesos se ocupan de la obesidad infantil. 
Métodos: estudio descriptivo, exploratorio, de abordaje cualitativo. Los datos fueron 
recolectados en el período de enero a junio de 2017, por medio de entrevistas 
semiestructuradas, en los domicilios de los niños atendidos en la Clínica Escuela de Nutrición 
de la Universidad Estadual del Centro-Oeste, en Guarapuava, Paraná. El análisis de los datos 
se basó en la técnica de Análisis de Contenido, modalidad temática. Resultados: participaron 
del estudio siete madres y un abuelo de niños con obesidad. De los datos surgieron dos 
categorías temáticas: "La influencia de la familia en los hábitos saludables" y "Obesidad infantil 
y preconcepto social". Consideraciones finales: el enfrentamiento de la obesidad infantil por 
las familias requiere el reconocimiento del papel decisivo que desempeñan en la formación de 
hábitos saludables durante la infancia. Además, programas de educación en salud que anhelan 
cambios de patrones alimentarios y estimulan la práctica de actividades físicas son importantes 
para mejorar la atención a la familia del niño obesa, pues permiten reducir daños y agravios 
provocados por el exceso de peso. 
Descriptores: Relaciones Familiares; Obesidad Pediátrica; Enfermería Pediátrica. 
 
INTRODUCTION 
 
Obesity is currently considered a 
major public health problem because it is 
a multifactorial chronic disease whose 
prevalence has increased in both 
developed and developing countries(1). In 
addition, increasing obesity at an earlier 
age has worried researchers and health 
professionals, especially for the damages 
and injuries caused by overweight to the 
child. By 2016, the number of overweight 
children under five was estimated at 
more than 41 million, of which 35 million 
were in developing countries(2). 
In Brazil, a nutritional epidemiological 
polarization is observed, marked by the 
persistence of malnutrition in certain 
regions and by the diffuse distribution of 
excess weight in others, which has 
reached indiscriminately the most diverse 
population groups. In this sense, it is 
necessary to reduce nutritional 
deficiencies and, at the same time, to 
promote healthy eating habits from 
childhood, in order to modify the 
nutritional, epidemiological and mortality 
profile of the population(3). 
For proper dealing with childhood 
obesity, promoting healthy eating is 
critical during childhood when tastes are 
 
 
 
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REPENF – Rev Par Enferm. 2019; 2(1):41-50. Oliveira AC, Ribeiro DM, Camargo EM, 
Soares LG, Abreu AS, Soares LG. 
being formed. It is also important that the 
child develops the habit of eating meals 
with his family at regular times, since the 
family’s eating habits and unhealthy 
practices of the caregivers are the main 
risk factors for childhood obesity(4). 
Much is discussed about the 
prevention of childhood obesity by 
encouraging breastfeeding and 
promoting healthy eating, as well as 
through regular physical activity. In 
addition, regulatory standards and 
controls of the food industry for children 
are developed worldwide to prevent the 
inopportune and exaggerated 
consumption of foods of low nutritional 
quality among children and provide 
greater family food security(5). 
In order to emphasize the complexity 
of childhood obesity, a qualitative, 
phenomenological studywith those who 
experience childhood obesity, that is, 
obese children and their parents, 
investigated factors that make it difficult 
to cope with this phenomenon and 
emphasized the need for more effective 
interventions that consider all the 
elements that surround the phenomenon, 
including family relations(1). In this sense, 
authors recognize the influence of family 
habits on children’s eating, as well as the 
higher incidence of childhood obesity 
when one or both parents are obese, 
since the relatives have a significant 
influence on their children’s habits(6,7). 
Considering the above, and the 
scenario of changes in the nutritional 
pattern, in which a significant increase in 
childhood obesity is observed and the 
importance of the family in this context is 
recognized, the present study is justified 
by the need to know better the dynamics 
of families of obese children in order to 
broaden the understanding of the 
phenomenon. Thus, this study aimed to 
understand how families of obese 
children deal with childhood obesity. 
 
METHODS 
 
A descriptive, exploratory, qualitative 
study carried out in the municipality of 
Guarapuava-Paraná (PR). Participants 
were eight family members of obese 
children followed-up at Nutrition Clinic 
School of the Centro-Oeste State 
University, through an extension project 
developed by the Nutrition course. 
The inclusion criteria included: to be a 
family member of a child participating in 
the childhood obesity group; to be over 
18 years old; and to live in Guarapuava-
PR. 
Data collection took place between 
January and June 2017 by three 
researchers. Firstly, telephone contact 
was made with the possible participants 
to be, in which we explained the 
objectives and procedures involved in the 
study and invited them to participate. 
Then, through acceptance, home visits 
were scheduled for semi-structured 
interviews, conducted by guiding 
questions. The interviews lasted 
approximately 20 minutes, were recorded 
and later transcribed in full. It is 
emphasized that the interview was not 
performed in the presence of the child, so 
that the relatives could express 
themselves with greater freedom 
regarding the phenomenon researched. 
After transcribed, the data were 
worked through the technique of Content 
Analysis, thematic modality, proposed by 
Bardin(8), which contemplates a set of 
techniques of communication analysis 
aiming to obtain, through systematic 
procedures and objectives of describing, 
the content of the messages, indicators 
that allow the inference of knowledge 
regarding the conditions of reception of 
these messages. The three phases were 
covered: (i) pre-analysis, which consists 
in the organization of the collected 
material, when performing floating 
reading, to formulate hypotheses, which 
supported the elaboration of indicators, 
through text cuttings in the analysis 
documents; (ii) exploration of the 
material for the definition of the 
categories by means of the identification 
of the registration units corresponding to 
the segment of the message, in order to 
understand the exact meaning of the 
registration units; (iii) treatment of the 
results, for inference and interpretation of 
the data, for highlighting the information 
for analysis, culminating in inferential 
interpretations, moment of reflexive and 
critical analysis(8). 
In compliance with the guidelines for 
human research in Resolution 466/2012 
of the National Health Council, the project 
 
 
 
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REPENF – Rev Par Enferm. 2019; 2(1):41-50. Oliveira AC, Ribeiro DM, Camargo EM, 
Soares LG, Abreu AS, Soares LG. 
was previously submitted to the Ethics 
Committee in Research with Human 
Beings of the Centro-Oeste State 
University, being approved under opinion 
no. 684.231. All participants signed the 
Free and Informed Consent Term in two 
copies and were kept under anonymity, 
so that they will be cited in this study only 
by acronyms, followed by a number 
corresponding to the order of the 
interviews, for example: interviewee 01 
was presented as E1. 
 
RESULTS 
 
Characterization of study population 
The age of the children whose family 
members participated in the study 
ranged from six to ten years; five were 
girls and three boys. On average, they 
had been participating in the university’s 
extension project for one year. 
Regarding to the characteristics of the 
relatives, the majority was mother and 
only one was the grandfather. Almost all 
of them had less than six years of study, 
except one mother, who had higher 
education. The average income was 
between one and two minimum wages 
and, in the households, there were four 
people, on average. 
The analysis of the speeches revealed 
two thematic categories: “The influence 
of the family on healthy habits” and 
“Childhood obesity and social prejudice”. 
 
The influence of the family on 
healthy habits 
It was possible to identify, through the 
speeches, that families recognized 
themselves as the main influence in the 
development of children’s eating habits, 
since all the actions they performed were 
reproduced by the children during the 
development process. This aspect can be 
verified in the following statements: 
 
“I’m not eating salad, he’s probably not going 
to eat either, I know that ... everyone here sits 
around [referring to physical activity]” (E2). 
 
“Maybe if the adults practiced some sport, she 
would be more excited to do it too” (E4). 
 
“There was one time he asked if I did not want 
to play ball with him ... I said that later I 
would, but I did not go” (E1). 
 
According to the interviewees, the fact 
that they worked and, thus, were absent 
from home during most of the day, had 
an impact on the dietary habits of the 
family, and therefore of the children, as 
expressed in the following statements: 
 
“After six o'clock I go to school, but, all day 
long, she’s eating her ‘junk’. Dinner is at the 
grandmother’s. Then she eats with the 
grandmother, eats with her father, and when 
I get home, sometimes she says she’s hungry, 
that nobody gave her anything to eat. “I'm in 
not sure, so I give her food the same way” 
(E4). 
 
“Rice, for a long time, I tried to cook the whole 
one, but, as a matter of time, I would come 
from work at lunch, but how about cooking 
time?” (E2). 
 
In addition to eating habits, the 
interviewees also mentioned difficulties 
for regular physical activity. They 
claimed, above all, lack of time and 
reduced home space: 
 
“There is no room here, it’s dangerous on the 
street and we work all day, we cannot get her 
to play, to spend energy” (E2). 
 
However, some relatives, aware of the 
importance of physical exercise, 
encouraged children to practice physical 
activities continuously, despite the 
difficulties to start and keep them: 
 
“Here at home even alone she does physical 
activity and she loves it, I start and I stop. He 
cannot wait to come to the group [follow-up 
of the University extension project, he loves. 
On vacation she will miss it” (E7). 
 
In the course of the research, we also 
observed another point that deserves to 
be highlighted: the risk of differentiated 
eating at the weekends, which is often 
mentioned by family members as a 
synonym of leisure. It is pointed out that 
the term leisure was often associated 
with the consumption of caloric and 
unhealthy foods at the weekend, to 
please children. The following statements 
shows this behavior: 
 
 
 
 
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REPENF – Rev Par Enferm. 2019; 2(1):41-50. Oliveira AC, Ribeiro DM, Camargo EM, 
Soares LG, Abreu AS, Soares LG. 
“On weekends we eat different things, some 
junk” (E4). 
 
“There’s always that one: ‘Oh, I’m going to 
take a little goodie and this and that’. It does 
not good because he getsused to the wrong 
way” (E2). 
 
Other respondents stated that they 
somehow tried to control the children’s 
diet, as they considered the food pattern 
they keep being exaggerated. Thus, they 
sought to eliminate some foods that they 
considered to be the most harmful to 
health: 
 
“The other day he finished eating some 
donuts, then he got a yogurt, finished the 
yogurt and still wanted me to warm up the 
pasta left over from lunch at three o’clock in 
the afternoon for him to eat ... then he got up 
and went to get a cereal bar to eat” (E2). 
 
“Pizza is not always, but we buy soda, ice 
cream, chocolate, fritters, popcorn, whatever 
crap she eats” (E4). 
 
“In the morning it’s coffee with milk, bread 
and butter, seldomly a ham, because you 
must cut it, because otherwise he would eat 
only ham and cheese. Rice he does not eat at 
all, but if I make rice dumpling, which is fried, 
he gobbles” (E6). 
 
Also, in order to control the 
consumption of certain foods, some said 
to follow the recommendations of health 
professionals. However, when the child 
refused to eat what had been indicated, 
they allowed them to eat only the 
preferred foods among the others, which, 
according to them, made it difficult to 
cope with childhood obesity in the family. 
Thus, the guidelines were often not 
applied in practice, as the following 
statement reveals: 
 
“I would make his food just like they directed 
me, very colorful. And he ate only the meat, 
the rest he left. Every day like this, and I as a 
mother, I prefer to give what he wants than 
seeing him not eating” (E3). 
 
In summary, in this category it was 
evident that eating habits and regular 
practice of physical exercise among 
obese children are considerably 
influenced by the habits and routines of 
their families. In addition, although 
family members identify harmful eating 
habits in their children’s daily lives, 
routine work and lack of time prevent 
changes in lifestyle. 
 
Childhood Obesity and Social 
Prejudice 
In this category, it was possible to 
show, through the statements of the 
participants, that obese children suffer 
from prejudices, which demands family’s 
skills to help them face this situation: 
 
“She talks a lot, makes new friendship easily, 
but nowadays she has been discriminated” 
(E5). 
 
“There are children who call her chubby. Then, 
sometimes in the van they say, ‘I will not sit 
on beside you, you’re chubby’” (E7). 
 
Dealing with behavioral and 
psychological conditions is also essential 
because social prejudice and judgment 
can alter children’s behavior and 
compromise their health: 
 
“Other kids end up calling him fat, chubby. He 
gets upset and sad at times” (E3). 
 
“She is very friendly, good and well behaved. 
The problem is when some child calls her 
chubby, then she comes crying at home” (E7). 
 
By identifying situations of prejudice 
and discrimination, which are known to 
cause sadness to the children, parents 
were very concerned about offering 
support to their children so that together 
they could face obesity and deal with its 
consequences: 
 
“Bullying is something we talk at home, we 
always talk about everything. We give enough 
freedom for him not to keep to himself” (E3). 
 
“When she was younger, she was more active, 
after she became chubbier, she stopped, she 
likes to go, but I think she is ashamed to run, 
because there are some that are not so 
chubby. We want her to try because, in 
addition to helping with weight loss, she 
makes friendships” (E8). 
 
It was identified that families lived 
daily with the prejudice and 
discrimination associated with childhood 
 
 
 
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obesity and, therefore, encouraged the 
children to share their anguish. They also 
encouraged them to approach other 
children and make new friends, hoping 
that this would help them overcome 
emotional distress. 
 
DISCUSSION 
 
As to dealing with childhood obesity, it 
is central that the family recognize itself 
as a provider of healthy habits, or not, for 
children. In this regard, it was evident in 
this study the participants’ recognition 
that the beginning of obesity is linked to 
harmful habits of the family, both food 
and those resulting from lack of physical 
exercise. A similar situation was observed 
in a study carried out in two public 
schools in the interior of São Paulo, in 
which the parents identified themselves 
as part of the children’s obesogenic 
environment(9). 
Another aspect recognized by the 
literature and evidenced in the present 
study concerns the absence of parents, 
who often work during most of the day, 
which is known to interfere with family 
life. This absence compromises the 
exchange of daily experiences between 
family members, which are essential to 
the child who is establishing their habits, 
either by the meal offered at the right 
time, by the choice of the correct foods, 
or by the strengthening of family ties(10). 
However, overcoming this problem 
there may be many challenges. The study 
recognizes that parent-child involvement 
is often difficult due to lack of time to 
supervise nutrition and physical 
activities, and 85.7% of the children and 
adolescents interviewed showed that 
inadequate eating habits were associated 
with family psychodynamics(11,12). 
Investigating the phenomenon more 
deeply, a qualitative study carried out in 
a city of Minas Gerais showed that family 
caregivers perceived physical and 
psychosocial impairments in the quality 
of life of overweight and obese children 
and adolescents(13). 
Health professionals should work to 
ensure that the family recognizes the 
problem of childhood obesity as 
something shared by all members, and 
treatment should consider the groups’ 
histories, sufferings, conflicts, values, 
cultural beliefs and knowledge(14). 
Therefore, authors point out the need for 
psychotherapeutic treatment for both 
patients and their families in dealing with 
obesity(12). 
In order to promote a healthy lifestyle 
by the children, the Ministry of Health 
established the need to promote the 
energy expenditure of this population, 
which involves, among other actions, the 
encouragement of physical activities in 
the family(4). The parents’ lifestyle 
influences, even unconsciously, the 
construction of a nutritional and life 
pattern that will determine, or not, the 
child’s obesity. Thus, changes in family 
structures, gender roles, and the values 
of a capitalist society can be considered 
as determining factors for overweight and 
childhood obesity, so that one way to 
achieve improvements in health care for 
children may be to strengthen these 
institutions(15). 
A literature review on the influence of 
physical exercise on childhood obesity 
showed that overweight makes it difficult 
to perform this type of activity. In 
addition, the lack of willingness of obese 
children to do physical activity has 
attracted the attention of different 
authors, who point out the decrease in 
the physical performance and the 
parents’ irregular habits as obstacles to 
the confrontation of obesity. On the other 
hand, the decrease in BMI and cholesterol 
and the improvement of body 
composition are considered some of the 
benefits of regular practice of physical 
exercise in the family(16). 
Although considered a source of 
pleasure, food should not be capable of 
compromising health by inadequate 
consumption. Although the habit of 
eating more caloric foods on weekends 
should not be strongly criticized, the 
child’s ability to develop a preference for 
such foods and desiring to eat them daily 
is troubling because they are tasty and 
therefore naturally instigate the 
consumption. In addition, obesity 
prevalence has increased inmost 
industrialized countries as a result of 
overeating, promoted by easy access to 
highly palatable foods, together with high 
concentrations of salt, sugar, 
preservatives and high calories(17). 
 
 
 
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The difficulty in controlling food 
emerged from the speeches of the 
participants of this study as something to 
be wary, since, given the children’s 
demand or to stop a crying crisis or even 
a temper, they allowed them to consume 
only the food of their choice. Authors 
claim that this parents difficulty in 
denying certain foods to their children or 
demanding a healthier diet is common, 
especially when they feel guilty about 
having spent the day at work(18). It is a 
situation that not only contributes to the 
increase in weight and risk of comorbidity 
but also makes it difficult for the child to 
be treated by adhering to healthy habits, 
stimulated in the present study by 
participation in the extension project. 
The evolution of society was 
accompanied by the production of various 
types of food, which were developed to 
guarantee greater acceptance of the 
population and, therefore, greater 
consumption and commercialization. New 
ingredients were used to produce 
increasingly attractive and tasty foods 
that could catch the attention of children. 
However, in addition to the fact that 
these products have reduced the quality 
of nutrients, consumption and easy 
access have been banalized, as well as 
the association of these foods with 
moments of fun and leisure(19). In this 
context, parents have the difficult task of 
controlling the consumption of these 
products among children, given the 
influence of the family in this context, 
which must be prepared to face the 
challenges involved in the necessary 
control of children’s eating patterns, 
especially when there already are 
associated comorbidities, such as juvenile 
diabetes mellitus(20). 
Study finds that the eating to control 
the emotions of children is something 
that can also contribute to obesity in 
childhood. In this case, the fact that 
parents offer food for the purpose of 
alleviating feelings of emotional 
deprivation will make them frequently 
offer the child, who will want them 
frequently, many times exaggeratedly(21). 
Thus, the parents’ lifestyle unconsciously 
influences the construction of a 
nutritional and life pattern that will 
determine the child’s obesity(15,22-25). 
It is important to emphasize that 
prejudice is one of the main problems to 
be faced by children who are overweight, 
especially in school settings(13). The 
discrimination obese children and 
adolescents suffered is increasing, and 
the impacts are observed early: smaller 
group of friends, less affection of parents 
and worse school performance(19). Social 
issues involving childhood obesity will 
largely contribute to behavioral changes 
and may lead to psychological problems 
in children. 
When obesity affects children and 
adolescents, it is common for them to 
develop symptoms suggestive of 
depression, expressed by symptoms such 
as attention deficit, hyperactivity, low 
self-esteem and behavioral disorders, 
impairing their development in this stage 
of life(26). Studies also mention the 
existence of stigmatized patterns in 
society, which favor the development of 
symptoms of anxiety, depression and 
stress among obese children and 
adolescents, with impairments in their 
intrapersonal and interpersonal 
relationships(27). In this way, providing 
psychological support is as important as 
guiding and encouraging the 
adoption/maintenance of healthy lifestyle 
habits. Providing security, acceptance 
and encouragement enables more 
effective dealing with this issue(28). 
 
FINAL CONSIDERATIONS 
 
The results of this study show that 
families recognize the decisive role they 
play in developing healthy habits on the 
part of children. However, some 
difficulties faced by family members for 
the adoption of good life practices for 
themselves and, consequently, for 
children, became evident. Social 
demands, especially lack of time due to 
working, are the main reasons of the 
problem. 
Parents need to be sensitized about 
the consequences of obesity so they can 
promote changes in family dynamics. 
Therefore, it is suggested that the whole 
family, and not only the child, should be 
followed up by offering care services to 
the obese child at school, at the health 
service or at outpatient clinics. 
 
 
 
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The family’s participation in the 
process of dealing with obesity is 
unparalleled, for the simple fact that 
everything the child observes and learns 
in the home will reflect in their daily lives. 
In this way, for him/her to achieve 
progress and modify her life habits, the 
support of parents and relatives is 
necessary. 
Social prejudice was also identified in 
this study as a problem to be faced. 
Social factors, related to the prejudice 
associated with obesity, influence the life 
and feelings of these children. 
Knowing the individuality of each 
family is essential, since each one can 
present different factors that increase the 
risk for obesity. Psychological 
components may contribute to a vicious 
cycle and favor weight gain and the 
development of other comorbidities. 
Therefore, the treatment of obesity is 
complex and requires the involvement of 
family members, since they are mainly 
responsible for teaching and encouraging 
healthy habits, as well as for identifying 
problems in the children’s organic and 
emotional development. 
It is suggested that health education 
programs to address childhood obesity 
should privilege family care so that they 
can reach their primary goal of action 
(the child), because when they work only 
with the child patient, changing the 
dietary pattern becomes harder. In this 
sense, health professionals, when caring 
for obese children, should consider them 
in their family contexts, since eating 
patterns are inherited from the family. 
 
 
Individual contribution of authors: Oliveira AC; Ribeiro DM; and Camargo EM: contributed substantially 
to the collection, analysis and interpretation of data and to the writing of the article and its critical revision. 
Soares LG; Abreu IS and Soares LG: contributed substantially to the research conception or design and 
approved the final version to be published. All authors claim to be responsible for all aspects of the work, 
ensuring its accuracy and integrity. 
 
Submitted: 10/03/2019 Accept in: 30/06/2019 
 
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