“ <i>I thought I was normal</i> ” children’s understanding of overweight and obesity: a qualitative study in chile

BACKGROUND: Childhood overweight and obesity are prevalent in Chile and globally. Health care responses typically emphasise biomedical and risk-focused approaches, with limited attention to children's own perspectives. OBJECTIVE: This study explored how children clinically classified as overweight or obese understand health, growth and weight within health contexts. METHODS: Participants were recruited from primary care clinics in two municipalities in Santiago, Chile. Semi-structured online interviews were conducted with 18 children aged 10-12 years during COVID-19 restrictions, incorporating visual tools such as body silhouettes and body mapping to facilitate discussion. Data were analysed using reflexive thematic analysis. RESULTS: Three major themes were identified: Translating Fatness: everyday words and the softening of body labels; Body shapes, shame, and the making of 'unhealthy' bodies; and Making Sense of Measurement: Receiving, Interpreting and Negotiating Medical Labels. CONCLUSIONS: The study highlights that children actively interpret and negotiate weight-related messages, drawing on emotional, social, and cultural frames rather than biomedical ones. Clinical encounters can heighten body awareness and stigma. Clinical practice should prioritise non-stigmatising communication, value children's perspectives, and adopt approaches that support wellbeing during growth and identity development.