Family system characteristics from the obese child and parent perspective – a pilot study

Objective
The aim of the study was to assess family system functioning in obese children from the perspective of child and parent.

Material and methods
Forty-six dyads (child-parent) were included into the study. Children group comprises of 48% boys and 52% girls, aged 11-18 years (13.0 ± 1.9 years), with simple obesity (BMI > 97 percentile, BMI z-score 2.1 ± 0.3). In parents’ group, 87% mothers and 13% fathers were examined. The weight and height were measured, BMI, and BMI z-score were calculated, and Polish version of Family Adaptability and Cohesion Evaluation Scales by D. Olson was performed in all dyads. In parents, a questionnaire formulated for the research was applied.

Results
Only parents of 2 (7%) children had BMI within the normal range. According to the information given in the questionnaire, problems with weight in the family were declared by significantly less parents: 22 (48%). In parent’s opinion, low physical activity (87%) and inappropriate diet (87%) were the most common reasons for obesity, whereas psychological problems (65%) and poor physical fitness (65%) were the most its common consequences. The most effective therapeutic factors were to comply with diet (87%), increase physical activity (72%), and change of lifestyle of the child (65%). The families were assessed as balanced according to 57% of children and 30% of parents (p = 0.01). Also, cohesion index and main index were significantly higher in children’s perception then parents’ (p = 0.02, p = 0.004).

Conclusions
Most of parents, in majority also obese, underline the need of change only in child’s functioning; they do not see the need to change of their own habits and deny the presence of obesity in the family. Moreover, parents perceived cohesion in their families lower than children. Our observation confirms that obesogenic family with some aberration in its functioning could lead to many difficulties in treatment of obesity.