Journal of Obesity & Metabolic Syndrome

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J Obes Metab Syndr 2025; 34(1): 75-83

Published online January 30, 2025 https://doi.org/10.7570/jomes24052

Copyright © Korean Society for the Study of Obesity.

Parental Roles and Challenges in Managing Pediatric Obesity: Insights from Focus Group Interviews in Korea

Jieun Ju1, Jahye Jung1, Yong Hee Hong2, Minsoo Shin3, Yoon Lee4,* , Ah-Ram Sul1,*

1Division of Healthcare Research, National Evidence-Based Healthcare Collaborating Agency, Seoul; 2Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon; 3Department of Pediatrics, Korea University Ansan Hospital, Ansan; 4Department of Pediatrics, Korea University Anam Hospital, Seoul, Korea

Correspondence to:
Ah-Ram Sul
https://orcid.org/0000-0003-0331-5529
Division of Healthcare Research, National Evidence-Based Healthcare Collaborating Agency, 173 Toegye-ro, Jung-gu, Seoul 04554, Korea
Tel: +82-2-2174-2790
E-mail: ahramsul@neca.re.kr

Yoon Lee
https://orcid.org/0000-0001-9521-3575
Department of Pediatrics, Korea University Anam Hospital, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Korea
Tel: +82-2-920-6435
E-mail: ragabash@korea.ac.kr

Received: December 2, 2024; Reviewed : December 26, 2024; Accepted: January 9, 2025

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background: Pediatric obesity is a global public health concern. South Korea is witnessing a notable increase in obesity rates among children and adolescents, despite various governmental interventions. Parents play a crucial role in preventing and managing pediatric obesity, as they are typically the primary observers of their child’s weight and daily habits.
Methods: This study involved 10 parents of overweight or obese children and adolescents in South Korea, identified from a 2023 Student Health Examination. Focus group interviews were conducted to explore participants’ experiences, followed by a rigorous qualitative content analysis of the data.
Results: The analysis revealed one main theme, parental roles and challenges in managing pediatric obesity, that encompassed five categories: parental awareness and perception of pediatric obesity; causes of pediatric obesity; parental strategies for managing obesity; barriers to management; and support systems and resources. Parental recognition of their child’s obesity was predominantly initiated through student health examinations at school, and the cause of obesity was multifactorial. Parents use various strategies, such as dietary changes and exercise promotion, but face barriers, including stigma and resource constraints. Parents demand comprehensive support from schools, healthcare providers, and community programs to effectively manage obesity.
Conclusion: These findings highlight the need for tailored interventions to address parents’ specific obstacles in managing pediatric obesity. Enhancing parental awareness, providing clear information, and strengthening support systems are essential for preventing and managing pediatric obesity in South Korea.

Keywords: Pediatric obesity, Overweight, Parents, Focus groups, Qualitative research, Korea

Based on the ‘obesity fact sheet’ published by the Korean Society for the Study of Obesity, the prevalence of both obesity and abdominal obesity among adults has shown an increasing trend over the past decade, with a notable increase in obesity rates in those aged 20 to 39 years.1 Concurrently, the childhood and adolescent obesity prevalence rate has doubled from 9.7% (2012) to 19.3% (2021) despite government efforts.1,2 Pediatric obesity is one of the most prevalent chronic conditions in children and often persists into adulthood.3 This disease produces significant economic costs and increases the risk of complications, such as type 2 diabetes mellitus and dyslipidemia.4-6 The persistence of obesity from childhood to adulthood and its associated risks highlight the significance of early identification and interventions.

Parents play a vital role in shaping children’s dietary habits, physical activity levels, and overall health behaviors, which are key determinants of childhood obesity.7-9 Studies have demonstrated that parental influence can significantly impact the likelihood of childhood obesity. A meta-analysis of 23 studies found that children with obese parents are approximately twice as likely to be obese themselves due to shared environmental and behavioral factors.7 Interventions may be delayed if parents do not recognize their children’s weight as a concern. Although the relationship between childhood obesity and parental roles has been acknowledged globally,10,11 there is a limited amount of recent research on this topic in Korea. Therefore, further research is needed to explore this relationship within the Korean context.

Despite increasing awareness among healthcare professionals and policymakers about the health risks associated with pediatric obesity, there remains a significant gap in understanding how effectively this knowledge is communicated to parents.12 This study investigated the awareness and obesity management practices among parents of overweight or obese children and adolescents in Korea through focus group interviews (FGIs). We explored parental perspectives to provide insights for developing tailored interventions within the Korean context.

Ethical considerations

This study was approved by the National Evidence-based Healthcare Collaborating Agency (NECA) Institutional Review Board (IRB) in Seoul, Korea (approval nos. NECAIRB23-015, NECAIRB24-006). All participants provided informed consent prior to participation.

Study design

This research was a part of a project titled ‘Research on the development of active prevention strategies for pediatric obesity and complications,’ conducted by NECA. This study used FGIs to explore parents’ experiences regarding the prevention, management, and treatment of overweight and obese children and adolescents. FGIs constitute a qualitative research methodology that elicit comprehensive data through structured discussions on specific topics. FGIs typically involve five to seven participants and can capture detailed insights and personal expressions often missed in quantitative surveys. This method facilitates participant interaction, leading to new ideas and reflections that may not occur in individual interviews.13 The research firm Impact First Consulting Group conducted the interviews.

Participants and recruitment

Children and adolescents were selected based on the results of obesity screening in the nationwide 2023 Student Health Examination, which was conducted in elementary (grades 1–4) and middle school (grade 1) students (Table 1). This study included parents (mothers or fathers) living with their children or adolescents (Table 2). Initially, the participants were recruited from a panel managed by a research firm. Information on the study was shared on two professional FGI-sharing websites to encourage voluntary participation. Although 12 participants were recruited, two withdrew before the interview, resulting in only 10 participants. Participants who completed the interviews were compensated 200,000 Korean won (KRW), and those who resided outside metropolitan areas (Seoul, Incheon, and Gyeonggi) were reimbursed for round-trip transportation costs.

Data collection

Face-to-face interviews were conducted in two sessions (morning and afternoon) on July 6, 2024, using the FGI method facilitated by a professional moderator. Each session involved a group of four to six participants, with each interview lasting approximately 2 hours. All interviews were audio-recorded and transcribed for analysis. The questions were based on a semi-structured interview protocol that included questions on (1) awareness and management practices regarding obesity (four questions); (2) opinions on existing national health policies (four questions); and (3) feedback on matters that need improvement (three questions). Before the FGI sessions began, the participants were informed about the research objectives, methods, confidentiality of the interview contents, and their right to withdraw. Participants participated in the FGIs after providing written consent. Additionally, participants were informed that they could discuss any difficulties or stop the interviews at any time.

Data analysis

The interviews were analyzed using qualitative content analysis to describe textual differences and similarities.14 Two authors (Jieun Ju and Ah-Ram Sul) read the transcribed interviews multiple times for comprehension, extracted the relevant meaning units, and condensed them without losing their core meaning. The data were then entered into a computer template to ensure transparency. Codes were assigned to meaning units to understand the context. All authors participated in the analysis, comparison, and discussion of the codifications to identify similarities and differences. This iterative process resulted in five categories and an overall theme.

The main theme, ‘parental roles and challenges in managing pediatric obesity,’ comprised five categories: (1) parental awareness and perception of pediatric obesity; (2) causes of pediatric obesity; (3) parental strategies for managing obesity; (4) barriers to management; and (5) support systems and resources (Table 3).

Parental awareness and perception of pediatric obesity

Parental awareness and perception of obesity are critical components of pediatric obesity. Many parents initially recognize weight issues in their children through visible physical changes, such as rapid weight gain or a noticeable increase in body size. Subsequently, through school health screenings and other assessments, many parents realized that their children were obese upon receiving objective measurements.

“My child was born prematurely. Thus, I tried to feed her well to help her grow healthy. When I had to buy clothes for my child for kindergarten, I had to buy larger sizes. I felt a little bit strange. While I noticed my child was chubby, I never thought she was obese. It was not until she started elementary school and needed even larger clothes that I realized my child was indeed obese” (ID #4, mother of an 11-year-old girl).

“Starting from the fifth grade of elementary school, I began to notice that my child was gradually getting chubby, and the results of the student health examination confirmed that they were indeed obese. However, I did not think it was serious enough to warrant a visit to the hospital. Nonetheless, in middle school, I saw that his obesity worsened” (ID #8, father of a 14-year-old boy).

Cultural misperceptions can affect the judgment of whether a child is obese, with some parents viewing a plump child as healthy or robust rather than overweight. This misperception can delay the recognition of obesity as a significant health concern:

“My child was born prematurely; therefore, I was relieved to see her eating well. At approximately 8 months old, she started to look chubby, and, as she grew, I thought this was normal since she had a healthy appetite. I also believe the old saying that, ‘Weight gain leads to height growth.’ However, when my child reached the fourth grade of elementary school, I noticed that, while her weight was increasing, her height was not keeping up. We went to the hospital, and the doctor confirmed that my child was obese” (ID #10, mother of a 14-year-old girl).

Parents’ understanding of the health risks associated with obesity, including diabetes, hypertension, and other chronic conditions, varies significantly. Parents need to accurately perceive and acknowledge these issues to establish a foundation for effectively managing pediatric obesity.

“My child’s condition progressed to a prediabetic state. As her liver enzyme levels increased, she became gradually fatigued. We felt incredibly guilty for allowing the situation to deteriorate this far. We realized that if high blood pressure, high cholesterol, and diabetes develop before our child even enrolls in middle school, the consequences could be severe” (ID #5, father of an 11-year-old girl).

Causes of pediatric obesity

One significant contributor to pediatric obesity is consumption of high-calorie, low-nutrient foods, such as fast food, snacks, and sugary beverages, which are often influenced by convenience and marketing targeted at children. During the coronavirus disease 2019 (COVID-19) pandemic, many children became accustomed to consuming instant foods and leading sedentary lifestyles, and the transition back to healthy habits was and is challenging, with poor eating habits and low physical activity levels persisting after the pandemic.

“As my child transitioned from kindergarten to elementary school, she ate treats while socializing with friends. It seems that the types of food she consumes, particularly instant foods, have the most significant impact on her obesity” (ID #3, father of an 8-year-old girl).

“During the peak of COVID-19, my child was studying at home instead of going to school, leading to consumption of many instant foods” (ID #3, father of an 8-year-old girl).

Physical inactivity is crucial in the obesity epidemic, with many children engaging in sedentary activities, such as watching television or using electronic devices, instead of participating in physical exercise.

“My child spends a lot of time watching YouTube and recording videos to upload, which leads her to stay at home a lot” (ID #5, father of an 11-year-old girl).

Genetic factors can predispose some children to weight gain, although lifestyle choices often exacerbate this problem.

“DNA seems to influence obesity. I have a sweet tooth. Therefore, when my family shops together, we tend to buy a lot of sweet treats like chocolate, candy, ice cream, and soda. My first child is slim and does not like sweets, but my second child takes after me and loves sweet foods like tanghulu (sugar-coated fruit on a stick)” (ID #5, father of an 11-year-old girl).

Environmental factors, including parental health and lifestyle, socio-economic status, access to healthy food options, and recreational facilities, further contribute to the risk of obesity.

“My child was at a normal weight, but during the COVID-19 period, she started gaining weight due to eating a lot of late-night snacks and treats” (ID #7, father of a 14-year-old girl).

“My wife is unwell. My daughter does not have anyone to go out with. She occasionally goes out with friends, but spends most of her time at home and is becoming less active” (ID #3, father of an 8-year-old girl).

Parental strategies for managing obesity

Parents employ various strategies to manage and mitigate obesity in their children, often beginning with modifying their family’s dietary habits. Introducing healthier food options, such as fruits, vegetables, and whole grains, while reducing the intake of sugary snacks and fast foods is a common approach.

“We cut back on dining out and takeaway meals, and I started packing lunches for my child when she attended her after-school program. Although my child likes bread and rice cakes, I tried to limit flour-based foods as much as possible. We made a conscious effort to change our eating habits” (ID #5, mother of an 11-year-old girl).

Encouraging physical activity is another critical strategy, with parents involving their children in sports, regular exercise routines, and family-based activities.

“My wife and I decided to set a positive example for our child by taking table tennis lessons and joining badminton classes to boost our physical activity. However, we have found it challenging to maintain this consistently” (ID #8, father of a 14-year-old boy).

Some parents seek professional help from nutritionists, pediatricians, or obesity clinics to provide tailored advice and support. In such cases, medical professionals should provide structured dietary plans, physical activity recommendations, and continuous monitoring to ensure progress.

“My child attends an obesity clinic, where they receive consultations with the doctor, nutrition education, and exercise training. Each time we return to the hospital, we present detailed records of everything she has eaten and the exercises she has completed” (ID #10, mother of a 14-year-old girl).

Barriers to management

Several factors can hinder the management of pediatric obesity. A primary challenge in this effort is the social stigma associated with being selected for special programs. The fear of being labeled as obese and discriminated against by peers can significantly reduce participation in these initiatives.

“My child was invited to participate in a fitness class, but she felt too embarrassed to apply, fearing her friends would find out. Instead, she would prefer to go to a sports center where she does not know anyone. I hope to ensure confidentiality is prioritized” (ID #5, mother of an 11-year-old girl).

Parents also face time constraints and a lack of resources, limiting their ability to prepare healthy meals and engage in regular physical activities with their children.

“My spouse and I both work, so we face time constraints in caring for our child. It would be helpful if the government could provide more support with childcare” (ID #4, father of an 11-year-old boy).

Receiving conflicting information from various sources, including the media, healthcare providers, and social networks, can confuse parents. Thus, reliable and accurate information tailored to individual children should be provided.

“Usually, I gather a lot of information through YouTube or internet searches. I also hear a lot from colleagues and those around me. However, it is challenging to determine which information is suitable for my child” (ID #7, father of a 14-year-old girl).

Students often socialize with their peers by sharing meals between classes. Within South Korea’s strong emphasis on academic achievement, students typically view junk food as a reward for successful exam results. Owing to the Korean Scholastic Ability Test demands, the reduction or elimination of physical education programs complicates efforts to promote healthy lifestyles among students.

“My daughter relieves stress by eating when she is with her friends. Thus, she quickly gives in to temptation, and I find it challenging to impose restrictions on her. I also need to respect her privacy” (ID #7, father of a 14-year-old girl).

“The habit of binge eating comes from a reward mentality. For example, if my child did well on a midterm exam, she asks for pizza as a reward. Given that she did well, I feel obligated to reward her. I understand that this is partly because of the stress she’s experiencing” (ID #6, father of an 11-year-old girl).

“As college entrance exams approach, upper-level students often have their physical education classes replaced with other subjects. I think it would be beneficial to mandate physical education classes to increase students’ activity levels and support their overall health” (ID #2, father of an 8-year-old boy).

Implementing these strategies can be challenging, especially when parents worry about their relationship with their children.

“It is challenging for me to manage what they eat. I worry that if I start telling her not to eat, it might strain my relationship with my child” (ID #1, father of an 8-year-old girl).

Support systems and resources

Effective support systems and resources are crucial to assist parents in managing pediatric obesity. Schools are expected to play a significant role by providing nutrition education, promoting physical activity, and conducting regular health assessments that can alert parents to potential weight issues early.

“I wonder how it would be if we incorporated relevant health education into the school curriculum. Kids need constant reinforcement. They might not always listen to their moms, but they are more likely to pay attention to what their teachers say at school” (ID #9, mother of a 14-year-old girl).

Community resources, such as local health campaigns, recreational facilities, and support groups, provide additional avenues for parents to access information and engage their children in healthy activities. There is a consensus on the need for support in community sports programs in collaboration with relevant local organizations.

“Programs at community centers, such as welfare centers, often have limited capacity, leading to long wait times and making participation difficult” (ID #2, father of an 8-year-old boy).

Medical professionals, including pediatricians, dietitians, and obesity specialists, should provide personalized advice and structured programs to meet individual needs.

“Even when parents gather information from various sources, their expertise is limited, which creates challenges. Someone needs to determine how to apply this knowledge to each child, and I believe it would be beneficial if a qualified professional could take on that role” (ID #2, father of an 8-year-old boy).

Governmental policies and initiatives, such as national health campaigns and subsidies for healthy food programs, are expected to further bolster these efforts by creating an environment that supports healthy living.

“I believe that managing obesity in childhood can lead to better outcomes in adulthood. Therefore, I think the government must provide support and allocate funding for childhood obesity management so children can grow healthier” (ID #7, mother of a 14-year-old girl).

However, a lack of awareness of national policies and initiatives often highlights the need for enhanced promotional efforts.

“I searched for national policies, but I am still not sure. It seems there may be a lack of promotion. Do you agree?” (ID #3, father of an 8-year-old girl).

Our findings go beyond the dietary focus of previous studies15 and highlight parents’ essential role in managing pediatric obesity, underscoring both the challenges they face and the strategies they employ. By exploring the theme ‘parental roles and challenges in managing pediatric obesity,’ we gained deep insights into how parents perceive, address, and overcome obstacles to manage their children’s weight.

The results indicate that parental awareness and the perception of childhood weight issues often stem from observable physical changes. In addition, parents of premature children tend to let their children eat badly despite observed weight gain. Indulgent parental attitudes toward children, coupled with cultural norms that normalize such behaviors, can negatively influence children’s eating patterns, increasing their risk of obesity.16,17 This observation aligns with previous studies emphasizing parental awareness as a crucial precursor to effective obesity intervention.11,18 Misinterpretations of a child’s weight status, particularly the culturally embedded notion that obesity equals health, can hinder timely intervention for effective obesity management.19 Public health initiatives should prioritize recalibrating parental perceptions through targeted educational programs and awareness campaigns.12 These efforts may facilitate more accurate parental assessments and prompt interventions, potentially mitigating the long-term health consequences of pediatric obesity.

The causes of pediatric obesity are multifaceted and involve complex interactions between dietary habits, physical activity, genetic factors, and environmental factors.19,20 The persistence of unhealthy eating habits and sedentary lifestyles post–COVID-19 suggests that these behaviors are becoming the norm, highlighting the need for sustained interventions.21,22 Interventions targeting the reduction of pediatric obesity require a comprehensive approach that addresses its multifactorial etiology. Such programs should adopt a holistic framework and integrate evidence-based strategies to optimize dietary behaviors, enhance physical activity levels, and foster environments conducive to healthy lifestyle practices.23 Moreover, implementing such comprehensive programs requires interdisciplinary collaboration among healthcare providers, educators, policymakers, and community stakeholders to ensure sustained efficacy and a wide-reaching impact in mitigating the pediatric obesity epidemic.24,25

Parents employ various strategies to manage their children’s weight, including dietary modifications, family-based physical activity, and seeking assistance from obesity clinics. However, the effectiveness of these efforts is closely tied to the parents’ ability to maintain consistency and long-term commitment, which is often hindered by barriers such as social stigma, lack of time and resources, conflicting information, the characteristics of Korean children, and difficulties in implementing and sustaining obesity management strategies.26,27 In South Korea, there is widespread stigma surrounding obesity and its treatment at both at the individual and societal levels. This stigma often manifests in the belief that seeking obesity treatment is an admission of failure to maintain one’s physical appearance.28,29 It is crucial to foster a social environment that views obesity management and treatment not as a failure but as a necessary medical intervention for those affected to combat this misperception.13,26,30 The growth of this collective mindset would foster a societal paradigm wherein obesity treatment is acknowledged as a necessary component of healthcare rather than an indicator of personal inadequacy.

Support systems and resources are pivotal in helping parents manage pediatric obesity. This study emphasized the significance of schools, community resources, and government policies in providing essential support. Educational institutions are crucial in delivering nutritional education and promoting physical activity, whereas community and medical resources offer additional guidance and assistance. These findings align with the literature advocating for a comprehensive, multi-stakeholder approach to obesity management.24 The Korean government has implemented a multifaceted approach to address the growing concerns about childhood and adolescent obesity through various initiatives. These encompass the ‘Comprehensive plan for obesity prevention and control (2018-2022),’ the ‘Korean Children & Adolescents Obesity Study (KoCAS),’ and ‘The 5th comprehensive plan for safety management of children’s diet (2022–2024).’2,31,32 However, many parents of children and adolescents are unaware of these national policies or programs. Therefore, it is essential to enhance the use and effectiveness of these programs through more active promotion.

This study has several limitations, which call for caution in generalizing the findings. First, the relatively small sample size and geographical restriction to a specific region of South Korea limit the applicability of our results to broader populations and diverse cultural contexts. Cultural variations in parenting styles and societal attitudes toward obesity may further influence how these findings can be interpreted in other regions or countries. Additionally, the reliance on self-reported parental data may introduce potential biases, including social desirability effects and recall inaccuracies, which could compromise the validity of our results.

Future studies should aim to incorporate larger and more heterogeneous samples across diverse geographical regions to enhance the external validity of the findings related to pediatric obesity. Longitudinal study designs are crucial for tracking the dynamic evolution of parental roles over time. Additionally, research efforts should prioritize the development of evidence-based support programs specifically tailored to meet the needs of families and caregivers. Furthermore, the integration of primary healthcare services with community-based initiatives has the potential to facilitate sustainable and effective interventions for the management of pediatric obesity.

Effective prevention and management of pediatric obesity in South Korea requires a multifaceted approach that includes enhancing parental awareness, supplying comprehensive information, and strengthening support networks. These findings indicate that successful obesity management requires a shift in individual and societal perspectives, recognizing obesity as a medical concern rather than a personal shortcoming. Holistic support from schools, community resources, and government initiatives is essential to provide the necessary programs for parents to manage their children’s weight effectively.

Yong Hee Hong is an editorial board member of the journal, but she was not involved in the peer reviewer selection, evaluation, or decision process of this article. Otherwise, no other potential conflicts of interest relevant to this article were reported.

This study was supported by the National Evidence-based Healthcare Collaborating Agency in South Korea (grant nos. NECA-A-23-006, NECA-A-24-001).

Study concept and design: JJ (Jieun Ju), JJ (Jahye Jung), YHH, MS, YL, and ARS; acquisition of data: JJ (Jahye Jung) and ARS; analysis and interpretation of data: JJ (Jieun Ju), JJ (Jahye Jung), YHH, MS, YL, and ARS; drafting of the manuscript: JJ (Jieun Ju) and ARS; critical revision of the manuscript: JJ (Jieun Ju), JJ (Jahye Jung), YHH, MS, YL, and ARS; obtained funding: YL; administrative, technical, or material support: JJ (Jahye Jung) and ARS; and study supervision: YL and ARS.

General characteristics of interviewed parents’ children

ID Sex Month and year of birth Height (cm) Weight (kg) BMI Z-score BMI Percentile (%)
#1 Boy Jun 2016 131 40 2.44 99.3
#2 Boy Apr 2016 146 54 2.93 99.8
#3 Boy Jan 2016 130 36 1.81 96.7
#4 Boy Sep 2013 148 66 3.22 99.9
#5 Girl Nov 2013 140 60 3.53 100
#6 Boy Dec 2013 145 52 1.77 96.3
#7 Girl Jul 2010 160 60 1.10 86.3
#8 Boy Aug 2010 166 70 1.47 93.1
#9 Girl May 2010 152 70 3.03 99.9
#10 Girl Jan 2010 149 80 4.32 100

BMI, body mass index.

General characteristics of interviewed parents

ID Relationship to children Age (yr) Type of residence Detailed location
#1 Father 40 Metropolitan* Seoul
#2 Father 43 Metropolitan Seoul
#3 Father 44 Metropolitan Gyeonggi
#4 Father 46 Metropolitan Seoul
#5 Mother 40 Metropolitan Seoul
#6 Father 47 Non-metropolitan Gyeongsangnam-do
#7 Mother 42 Metropolitan Seoul
#8 Father 49 Metropolitan Seoul
#9 Mother 49 Non-metropolitan Busan
#10 Mother 47 Non-metropolitan Gangwon-do

*Metropolitan areas include Seoul, Incheon, and Gyeonggi.

Overview of main theme, categories, and associated subcategories

Theme Categories Subcategories
Parental roles and challenges in managing pediatric obesity Parental awareness and perception of pediatric obesity Recognition of child’s weight gain
Cultural perceptions of body weight
Understanding of obesity-related health risks
Causes of pediatric obesity Unhealthy dietary habits
Lack of physical activity
Genetic factors
Environmental factors
Parental strategies for managing obesity Efforts to control diet
Encouraging physical activity
Utilizing medical and professional support
Barriers to management Fear of social stigma
Parents’ lack of time or resources
Conflicting information from different sources
Characteristics of Korean children
Difficulties in implementing and maintaining obesity management strategies
Support systems and resources Enhancing school programs
Availability of community resources
Need for medical support
Importance of governmental policies
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