Peter Loader

Interaction in families with obese children

In a controlled study using recently developed and validated methods for eliciting and describing family interactions, a characteristic dysfunctional pattern of interaction was found in families with an obese child. The pattern differed from patterns predicted by previous workers on the basis of indirect evidence or non-systematic study. The pattern was present in all the families studied, but was more marked in the sub-group recruited from a local school, than from subgroups recruited through medical sources. This sub-group had a more positive attitude to obesity and a slightly lower degree of obesity. No common or characteristic interactional pattern was found in the controls. The results were not explainable in terms of demographic criteria, family structure or composition variables, or family emotional health. The findings are discussed in relation to a model of obesity as a family syndrome and a manifestation of psychosocial identity.

Emotional health of families and their members where a child is obese

A controlled study of families with an obese child showed a small but significantly greater impairment in family functioning when this was elicited and rated using clinical methods. However no significant impairment was found when functioning was elicited with standardized objective methods. Mothers of obese children rated their families as more dysfunctional than mothers of control children. Although the emotional health of individual members in obese families was not worse than in control families, significant differences in the family patterning of emotional health were found. The more overweight the obese child, the healthier the mother rated the family, and the better her own mental health as assessed by a self-report method; and in families of obese girls, the greater the degree of overweight, the worse the rated family functioning. The findings are integrated with the literature and a theoretical explanation in which obesity is seen as an identity disturbance is offered.