Lessons learned from a family-focused weight management intervention for obese and overweight children.

<bold>Objective: </bold>Treatment for childhood obesity is characterised by high attrition rates and failure to achieve weight maintenance. It is therefore important to develop more effective programmes. The aim of the present qualitative study was to explore the views of parents, children and health trainers to identify issues which can inform the development of more effective programmes.<bold>Design: </bold>A qualitative study combining in-depth interviews and focus groups. Participants were selected purposively from current and past attendees.<bold>Setting: </bold>WATCH-IT, a UK-based community child weight management programme.<bold>Subjects: </bold>Twenty-three families who had previously attended (or were currently attending) WATCH-IT were interviewed. Focus groups with ten trainers explored their views of the intervention.<bold>Results: </bold>Parents and children had different goals for involvement, with parents focusing on psychological benefits, while children concentrated on goals relating to weight loss and physical fitness. Parents were found to struggle to provide consistent support to their children and this was exacerbated by family dynamics. The child's commitment to lose weight, support from their family and a good relationship between the child and their trainer were viewed as important keys to successful weight management.<bold>Conclusions: </bold>The study will guide the design of existing and future programmes by providing insights into issues that challenge successful engagement. It highlights the possible value of exploring the therapeutic relationship between trainers and participants. [ABSTRACT FROM AUTHOR]