Table 6 Quotes on awareness and feelings towards overweight in children according to carers from Bandung, Indonesia

Characteristics of overweight

• P5: If it’s in babies, Ma’am, from here (pointing at her arms), we can see it from their arms. So, in Sundanese, gegeretan (Sundanese term- babies with fat folds; it looks as if their flesh have been sliced).

• P7: The size should be the plus one; otherwise it must be sewn. Hahaha

• P3: ... for example after they walk for a little while, they go hah hah hah (laboured breathing noises).

• P5: Sundanese people said that the way they walk is ngajegag (walking with the leg open, like frog legs), right?

• P8: Uh... the belly is bloated and it looks like the person is pregnant.

• P2: When you bring them out to walk, they get tired easily.

• P6: They run for a little bit and they are like (makes panting noises).

• P7: They are slow; they walk slowly.

• P5: So, for example, when the baby is 4 months old, the other child can lie flat on the stomach, but the fat baby can’t do it.

• P4: For example, babies his age are supposed to be in the standing and started to walking stage (but the fat baby cannot do that just yet).

 P6: Yeah, it’s like, the children seem to experience difficulties to move. It looks difficult for them to walk. I see that a lot, and I use to think, “That is overweight”.

• P5: It’s probably because she has tough bones, bigger bones and however much weight she loses she will never be as thin as other kids. The problem is, currently she moves slower than her younger sibling and she has breathing problems, too

• P7: If the person is overweight, he’s prone to diseases and becomes sick easily.

Food portion size in overweight children

• P9: So when I gave her the food, I gave her less, I don’t follow the serving size guidelines from the box.

• P1: For normal children, it’s just the standard serving...for the overweight children, they will have as much as adults.

• P3: My son (elementary school) eats the same portion as mine.

• P7: Like earlier this morning, before I came here, we have breakfast with fried rice. Well, after fried rice, he asked more, he asked for noodles. I gave him one pack of noodle, and he ate it until there’s nothing left.

• P4: In a day? Well, actually, he eats three times a day, but the portion is more than me. For me, for example, I eat one full plate. My child can eat up to three full portion.

• P6: She only eats zuppa soup as main meal.P2: How many bowls?P6: Only three bowls.

• P5: Because we think the children are still on the growth period (so we let the children eat a lot).

• P7: Parents are also afraid if the children get sick, because there are so many diseases right now.

• P6: So sometimes they make their children eat a lot to prevent them from getting sick.

Eating frequency in overweight children

• P4: My niece, 5th grade, 58 kg, she eats at 6 pm, then she eats again at 8 pm. Mostly, she eats meatballs, she rarely eats any vegetables.

• P2: A child should eat three meals a day right? This one eats more than three times and she eats noodles, sometimes two packages aren’t enough for her, only four is.

• P9: My (obese) child eats regularly, three times at home, but even when he has eaten and our neighbour offers him something to eat, he will eat it. When he comes to his aunt’s house and she offers him food, he will eat it.

• P7: He’s always eating. He never stops eating.

• P5: He eats four times a day, and he also eats snacks like bread, cakes, sweets.

• P2: He eats…he eats at noon. The others only eat in the morning and after Isya (the last Moslem’s prayer time in a day, in Indonesia, it’s at about seven o’clock p.m). When the others eat after Isya, my son also joins them. After that, he watches TV until 11 o’clock. Sometimes, at ten o’clock, he eats again. That means he doesn’t make a move (after his last meal), then he directly goes to sleep.

• P5: Yeah, people do that you know. My son, my eldest one weighs almost 70 k. He eats one meal at 10 am, and then another one at 12. In the afternoon, when he finally gets home, he eats another meal. He just wanders around the kitchen looking for food, and suddenly he has a plate full of rice.

• P4: For my child, if he eats regularly like three times a day, his weight is stable. Three meals: morning, noon, and afternoon around six pm. Stable, but once there are snacks. Oh, his weight goes skyrocketing.

Feelings about overweight children

• P5: Who doesn’t want a fat child?

• P7: They are cute. I want to pinch them.

• P2: I feel gereget (kind of loving something cute mixed with desire to pinch, in Sundanese), Ma’am.

• P8: Happy to see a fat child, but pity him as well

• P6: Because it’s a pity. It’s difficult. Yes, the fat children have difficulties to move. They become uh, they’re lazy, they sleep a lot.

• P7: Out of fear of becoming like A (name), so we limit our child’s diet...

• P9: Horrified.

• P7: When they’re little, it’s kind of cute (to be fat).

• P3: Yes, cute, like on TV.

• P6: It scares me.

• P1: If the child is too fat, sometimes I feel pity for him/her, just like the one on TV.

• P8: I feel sorry for him, Doctor.

• P8: When we look at the fat children, we’ll think they are cute…But actually it’s a pity, fat children are having difficulties to move.

• P6: I’m afraid my child will become that fat.

• P2: The problem is that they are vulnerable to diseases, I’m afraid of that. Underweight children are vulnerable to diseases, but so are the big ones, hahaha.

Sensitivity in carers of own overweight children

• P6: This doesn’t happen to my child, he is fat but healthy.

• P9: Well, when he runs around, he doesn’t get tired easily.

• P8: I don’t think a fat person gets tired easily because mine is fat (and he does not get tired easily).

• P5: My child, who is fat, is actually very active and can run quickly.

• P8: When he’s racing with his thinner friends, he runs faster.

• P4: Fat people are not always slower.

Children’s current weight and height

• P2: I just want it [my child’s weight] to be just normal, ascending in a straight line [on the KMS- Kartu Menuju Sehat (Health Card)].

• P3: I have too many under 5 children, everytime I go to Posyandu (community health post) to weigh them; I bring 3 or 4 children.

• P4: I thought that my child was the only short one, but it turns out that there are a lot of kids who are as short as he is.

• P7: Importantly, it must be according to the chart, or the doctor’s opinion. If the doctor says okay, I’ll be thankful.

• P6: I’m aware that I am short, so my children won’t be tall.