Family-Reported Barriers to Weight-Management Adherence in Children with Obesity: A Six-Month Longitudinal Study

Family participation is an essential component of pediatric obesity management. However, maintaining nutritional and physical activity recommendations over time can be difficult because children depend on parents and other caregivers for access to food, supervision and opportunities for physical activity. among children with obesity attending a private pediatric endocrinology practice in Bogotá, Colombia. 235 children from 200 families were followed up every 2 months for 6 months to describe barriers to adherence. Participants had a body mass index above the 95th percentile for age and sex. Families received nutritional and physical activity recommendations. At two months, 80 boys (65.6%) and 90 girls (79.6%) had reduced weight. At four months, the corresponding proportions were 49.2% and 63.7% and at six months they were 36.9% and 53.1%. Overall, the proportion classified as having reduced weight decreased from 72.3% at two months to 44.7% at six months. The most frequently reported barriers were limited parental time to perform physical activity with the child (55%), inconsistent support from grandparents regarding recommended foods (32%) and the child’s refusal to follow dietary or physical activity recommendations (18%). Limited parental time and inconsistent dietary support from grandparents were the most frequently reported barriers for pediatric obesity management.