What are the experiences, perceptions and expressed needs of adolescents living with obesity and their mothers in Indonesia? a qualitative multi-method study.

Abstract

This study aimed to explore the experiences, perceptions and expressed needs of adolescents living with obesity (ALOs) and their mothers. Data were collected through ALOs' diary journals, short-term ethnographic fieldwork at ALOs' schools and semi-structured individual interviews with both ALOs and their mothers. Reflexive thematic analysis was conducted using an inductive approach with two independent coders. The study was conducted at one paediatric outpatient clinic at Dr Sardjito Tertiary Referral Hospital and in three selected junior and one senior high schools in urban and suburban areas of Yogyakarta and Sleman, Indonesia. Twelve participants including 6 ALOs and 6 of their mothers. Data were collected through diary journals, a week of school-based observation and individual in-depth interviews with both ALOs and their mothers. Five key themes emerged: (1) Recognition, emotional responses and perception to obesity, (2) Awareness and desire for change, (3) Self-control and coping strategies, (4) Challenges in adopting a healthy lifestyle and (5) Support systems and weight management preferences. ALOs experienced bullying, shame and physical discomfort. They struggled with physical activity and diet due to social pressures and a lack of healthy food options at school. They believed that parental support, better nutrition literacy and regular reminders were crucial for improving their body weight. The adolescents' commitment to weight loss was driven by both internal motivations (eg, masculinity, family medical history) and external factors (eg, social and cultural pressures on body image). This study highlights the diverse psychosocial and emotional experiences associated with living with obesity, offering important insight into how ALOs and their mothers experience and navigate everyday life. These findings are essential for developing future human-centred obesity interventions that are both effective and empathetic.