Family and community pressure, obesity-related behaviours, and psychological wellbeing among female adolescents with overweight or obesity: a qualitative study

BackgroundAdolescent obesity has physical, psychological and social consequences. Family and community influences can be important in determining the eating behaviour, body image and emotional health of adolescents. Few qualitative studies have investigated female adolescents’ own perception of family and community related pressure around their weight.MethodsThis qualitative exploratory study used semi-structured interviews to investigate these experiences among 30 female adolescents aged 12–19 years (mean 16.3 years) with overweight or obesity. Weight status was classified against the WHO 2007 BMI-for-age reference. The study covered eating behaviour, criticism, emotional impact, and perceived approaches to managing obesity. Data were analysed using inductive thematic analysis.ResultsSeventeen participants (57%) met WHO criteria for obesity and 13 (43%) for overweight. Four themes emerged: (1) a conflicted relationship with food, characterised by dieting, restrained eating, and a cycle of restriction followed by overeating (n = 16); (2) experiences of criticism from parents, family members and the wider community (n = 20), most commonly around appearance and health; (3) psychological and life-choice implications, including self-consciousness and embarrassment (n = 25), low self-esteem, social withdrawal, and concerns about clothing, autonomy and future marriage (n = 22); and (4) motivation and perceived strategies for obesity management, including healthy eating, dieting, exercise, and medical interventions. Negative comments were mostly reported as unwelcome, whereas positive and health-related comments were reported as motivating.ConclusionPressure from family and community is a key component in how female adolescents with overweight or obesity perceive their weight, influencing behaviour, emotions, and social functioning. Obesity interventions should incorporate mental health, stigma reduction, and support for constructive family and community communication, alongside weight management.