Int J Qualitative Stud Health Well-being EMPIRICAL STUDIES Children’s understandings’ of obesity, a thematic analysis AMY L. FIELDEN, MSc, ELIZABETH SILLENCE, PhD, & LINDA LITTLE, PhD Psychology and Communication Technology Lab, Department of Psychology, Northumbria University, Newcastle-upon-Tyne, UK Abstract Childhood obesity is a major concern in today’s society. Research suggests the inclusion of the views and understandings of a target group facilitates strategies that have better efficacy. The objective of this study was to explore the concepts and themes that make up children’s understandings of the causes and consequences of obesity. Participants were selected from Reception (4 5 years old) and Year 6 (10 11 years old), and attended a school in an area of Sunderland, in North East England. Participants were separated according to age and gender, resulting in four focus groups, run across two sessions. A thematic analysis (Braun & Clarke, 2006) identified overarching themes evident across all groups, suggesting the key concepts that contribute to children’s understandings of obesity are ‘‘Knowledge through Education,’’ ‘‘Role Models,’’ ‘‘Fat is Bad,’’ and ‘‘Mixed Messages.’’ The implications of these findings and considerations of the methodology are discussed in full. Key words: Obesity/overweight, health behaviour, children research, qualitative research (Accepted: 13 July 2011; Published: 2 September 2011) The Health Survey for England 2009 illustrated that 65.9% of men and 56.9% of women have a body mass index (BMI) higher than 25 kg/m2, classing them as overweight, obese ( 30 kg/m2), or morbidly obese ( 40 kg/m2). Obesity is linked to many chronic illnesses, including type II diabetes, heart disease, and some cancers*specifically bowel and others within the digestive system (Renehan, Tyson, Egger, Heller, & Zwahlen, 2008). As a result, the direct cost to the National Health Service (NHS) of treating obesity was estimated to be between £991 and £1,124 million, for the 2001/2002 financial year (McCormick & Stone, 2007). Childhood obesity is of particular concern be- cause obese children are far more likely than children of a normal weight to become obese adults (Alexander & Sherman, 1991). The Health Survey for England 2009 showed that between 1995 and 2008, the percentage of overweight and obese girls rose from 25.5 to 29.2% and from 24.5 to 31.4% for boys. This is despite the fact that during the same period reported total energy intake in the United Kingdom (UK) fell by around 20% (Statistics on Obesity, Physical Activity and Diet England, 2006). These contradictory figures highlight the complexity of factors contributing to obesity, pointing to issues such as levels of physical activity, which have significantly fallen over the past two decades (Prentice & Jebb, 1995). Many other factors influence incidences of obesity. The negative impact of childhood obesity causes the greatest concern and needs to be further understood. Obese children are more likely to become obese adults and experience increased health problems. Knowler, Pettitt, and Saad (1991), highlighted the links between childhood obesity and a poor immune system, risk of raised blood pressure, and cardiovas- cular problems. Studies have also identified that overweight and obese children are more likely to suffer psychological problems associated with low self-esteem, bullying, and social exclusion (Breat, Mervielde, & Vandereycken, 1997). On an international scale, obesity can be seen as a problem of the developed world, a result of eco- nomic wealth, high food availability, and low levels of manual labour leading to lower levels of physical activity. This is in conjunction with high levels of car ownership and wide ranging public transport systems adding to the problem. In short, at the heart of obesity lies a homeostatic biological system that Correspondence: Amy L. Fielden, P@CT Lab, Northumberland Building, Northumberland Road, Newcastle-upon-Tyne, NE1 8ST, UK. Tel: ( 44) 0191 2273716. E-mail: a.fielden@northumbria.ac.uk #2011 Amy L. Fielden et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 3.0 Unported License (http://creativecommons.org/licenses/by-nc/3.0/), permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. 1 Citation: Int J Qualitative Stud Health Well-being 2011, 6: 7170 - DOI: 10.3402/qhw.v6i3.7170 (page number not for citation purpose)