Obesity Prevention/Treatment Qualitative studies among obese children and adolescents: a systematic review of the literature J. Lachal 1,2,3 , M. Orri 1,2 , M. Speranza 4 , B. Falissard 1,2,5 , H. Lefevre 1,3 , QUALIGRAMH 1 , M.-R. Moro 1,2,3 and A. Revah-Levy 1,2,6 1 INSERM, U-669 PSIGIAM, Paris, France; 2 Université Paris Descartes, Sorbonne Paris Cité, Paris, France; 3 Maison de Solenn, AP-HP, Hôpital Cochin, Paris, France; 4 Centre Hospitalier de Versailles, Service de Pédopsychiatrie, Le Chesnay, France and EA 4047, Université de Versailles Saint-Quentin; 5 Département de santé publique, AP-HP, Hôpital Paul Brousse, Villejuif, France; 6 Centre de Soins Psychothérapeutiques de Transition pour Adolescents, Hôpital d’Argenteuil, Argenteuil, France Received 11 July 2012; revised 4 November 2012; accepted 4 November 2012 Address for correspondence: Dr J Lachal, Inserm U669, Maison des Adolescents, 97 Boulevard de Port Royal, 75679 Paris Cedex 14, France. E-mail: jonathan.lachal@gmail.com Summary Childhood obesity is a complex condition involving medical, social, moral and cultural issues. Qualitative approaches are of great value in understanding this complexity. This meta-synthesis of 45 qualitative studies deals specifically with the issue of obesity in children and adolescents from different perspectives – those of obese children and adolescents, of parents, and of health professionals providing support to the family. Our aim was to obtain a coherent view of child and adolescent obesity, focused on clinical and personal experience. The themes derived from the synthesis process fall under three main axes: ‘Seeing others, seeing oneself’, ‘Understanding others, understanding oneself’, and ‘Treating others, treating oneself’. It emerges that participants in all three groups had equal difficulty in perceiving and labelling obesity, mainly because of their lack of any real common ground. The insufficiency of shared representations destabilizes the therapeutic relationship and its construction: an important issue in the doctor– child–parent relationship in this context is the need to exchange their viewpoints of obesity. Health workers may also expand their understanding of obesity by incorporating the personal experiences of obese children and their parents in order to match treatment plans to their needs and expectations. Keywords: Child, meta-synthesis, obesity, qualitative research. obesity reviews (2013) 14, 351–368 Background The prevalence of obesity makes it a major public health concern – 500 million people are thought to be affected according to the World Health Organization (1). Obesity also affects children, and the number of obese children is very high all over the world (2,3). For instance, the preva- lence of childhood obesity in the USA is estimated at 11.9% (4). The consequences of obesity in childhood – which can be orthopaedic, neurological, respiratory, hepatic, endo- crine, psychiatric and cardiovascular – are well known today (5–7). Obesity is a complex condition to understand, involving as it does medical, social, moral and cultural issues (8). It can be defined in a variety of ways. Medically, it is charac- terized by a single value – the body mass index (BMI) – its cut-off points are the basis today for considering that a health risk exists (1). Socially, it is associated with disability and vulnerability and sometimes even hampers social inte- gration. Culturally, representations vary considerably; an obese body is associated with poor health in western coun- tries, while in other regions of the world it can signify power, strength and health (9). Morally, attitudes range from an accusatory viewpoint, which sees obesity as the result of a lack of will power and self-control to a medical viewpoint according to which, excessive weight is the con- sequence of organic disorders that are independent of any form of mental control (10). obesity reviews doi: 10.1111/obr.12010 351 © 2012 The Authors obesity reviews © 2012 International Association for the Study of Obesity 14, 351–368, May 2013