Table 5 Quotes on factors contributing to weight according to carers from Bandung, Indonesia

Dietary factors

• P1: It’s mainly caused by one’s dietary habit that is too... where one does not have appropriate portions. Also, frequent eating can cause obesity.

• P4: It could be that, Ma’am, aa, obesity comes from eating too many sugary foods, excessive sugar consumption. Or it could be from the snacks, Ma’am; they’re not very healthy.

• P7: Even if he has eaten two packs of noodles, if he has not eaten rice, he’ll consider it as if he hasn’t eaten yet.

• P2: They eat too much

 P5: It has to be empat sehat lima sempurna (Four Healthy, Five Perfect – an Indonesian ideal meal incorporating carbohydrates, proteins, vegetables, fruits, and milk).

• P2: Like when you sleep right after you eat, lack of exercise, eating snacks… these things make you bigger.

• P9: Aa, they eat a bowl of noodle and a plateful of rice.

 M: So, noodles and rice. How often do they eat that, Ma’am?

 P9: Aa, sometimes they eat those twice a day.

 P5: Noodle can also cause obesity.

• P7: Initially, A (name) drank too many sugary drinks like... something like Teh Gelas (sugary drinks brand). So he became obese.

• P1: We are Indonesians, we have to eat rice.

• P7: She has a big appetite, drinks a lot of milk, and her father is also fat. Could that be a factor?

• P2: I rarely consume noodles now, when I do, I only put half of the MSG. Hahaha.

• P6: So you add salt to it?

• P2: Aa, nope, I add eggs and mix them with butter, so it has the right amount of saltiness from the butter.

• P6: But that’s where the fat come from (the butter).

• P4: It can be the quantity of the milk.P5: It can be how much the children drink the milk.

• P3: Maybe it’s because they drink a lot of milk.

• P4: For example, he drinks brand A, although he only drinks a little, but the composition is different. Maybe one of the compositions stimulates the appetite.

Activity levels and sedentary behaviours in children

• P1: After they eat, they’re just sitting down, watching TV. So that, aa, there is no chance for them to burn the calories. That might have caused (the person to be).

• P7: Fat.

• P2: He is out somewhere to play (right after he came home from school). Changes his uniform, then goes straight outside to play.

• P3: After school my daughter usually have her lunch, then….. Then after lunch, that’s in... in the afternoon, aa, she is joining Qur’an (Moslem’s holy book) recitation.

• P7: Maybe, being fat is caused by lack of...maybe lack of activities?

• P8: They fly kites.

• P5: They just run around.

• P8: They ride bicycles, Doc.

• P7: Right, bicycles.

• P6: Lifestyle.

 M: What kind of lifestyle?

 P6: One that lacks exercise.

• P8: My child can’t stand staying at home, so he plays outside.

• M: What do you think about the physical education class at school?

• P6: It’s not long enough.

• P4: Right, it’s not enough.

• P3: They mostly play outside, of course.P5: Yeah, outdoors.

• P8: He reads Qur’an in the evening.

• P5: He reads the Qur’an, ma’am.

• P3: My child reads the Qur’an in the evening and afterwards he plays for a while M: Outside or inside the house?

• P3: He plays outside.

• P4: Video games.

• P5: This (imitates someone playing video games) isn’t being active.

• All: Hahaha

• P4: Because, the children can, umm, even if they don’t go outside, they can do the activities at home.P3: They can play around the house, moving here and there, right?

 P4: Yes. They can go up and down.

 P5: On the stairs, right?

• P2: For my son of course it’s inside.

• P3: Heeh, he arrived in the afternoon, and then go straight to his math course. And then it’s Maghrib (praying times-6 pm) when he came home; he only spends some time outside the house on Saturdays and Sundays, and that doesn’t happen a lot either.

• P2: Yeah, same here. Even on Saturdays and Sundays he doesn’t spend much time outside.

Heredity

• P1: Those who have inherited it from....

• P6: From the parents.

• P3: Being large is in my family’s blood

• P8: But he inherits it from his father. His father is also fat.

• P2: That’s when an excessive diet is not balanced by exercise, which was mentioned earlier. Heredity is a factor that can play into this, too, right? Like genes? Right?

• P9: People in the village always think like this, it’s normal if the children are fat because the father is also fat, just like that.

• P8: There’s the heredity factor.

• P3: Yes, it’s inherited.

• P5: That’s why the children become fat.

• P7: If the parents were fat, the children would also be fat.

• P1: Heredity.

• P2: It can be inherited.

• P4: Fatness can be inherited.

• P2: It’s inherited. I am one of the big families. Yeah, my husband and I, we’re big and tall people.

• P7: Several diseases are heredity like cancer, asthma, but not overweight.

• P8: The shape and size of the body is probably not affected by heredity.

• P6: It might be both. Maybe, the fat people already has a heredity factor and then…

• P5: It’s worsened by wrong dietary habit.

• P6: The heredity, maybe, heredity factor?

• P4: Do you mean genetic factor?

• P6: So, their bones are naturally big.

• P5: Yes, since they were little, it’s already big.