Research with kids and parents on Medicaid in Dallas, Texas, and California’s Bay Area, along with interviews with healthcare providers and experts across the country, uncovered stories of stigma and frustration. Parents spoke of the daily challenges of balancing multiple jobs, sourcing affordable healthy food, and finding time to make necessary lifestyle changes. They described rushed pediatric visits that left them with unclear next steps and feelings of blame. Provider conversations echoed these struggles, noting time constraints and limited follow-up options.
Ultimately, food had become a daily torment for these families. Eating was unavoidable and also one of the few affordable indulgences low-income parents were able to provide. Once kids left their own homes, they were surrounded by unhealthy temptations, making it feel impossible for parents to maintain control. The popularity of costly new weight-loss medications and surgical procedures added another layer of complexity for families who had been underserved by—and therefore distrustful of—America’s healthcare system. With so much of the responsibility placed on parents to self-direct care, inequities deepened, adding to the burden of families already at a breaking point.
To design a path forward, IDEO and IDEO.org mapped a family’s needs before, during, and after pediatric visits. This work revealed critical parts of the journey where families needed more support: recognizing early signs of obesity, navigating provider conversations, and sustaining healthier habits at home.
These insights informed a theory of change framework that provides actionable guidance for stakeholders involved in obesity care. Grounded in three opportunity areas along the patient journey—building awareness, confidence, and capacity—the framework highlights how trust, dignity, and systemic support can lead to lasting outcomes.
IDEO and IDEO.org also developed 10 user-centered concepts spanning digital, physical, and service offerings to reduce stigma and empower families to sustain healthier lives. These ideas address dignified diagnoses and structural inequities, among other pressing issues. Complementing these concepts, IDEO created a short documentary of a mother discussing her family’s experience navigating childhood obesity to help pediatric providers—many of whom have had very different lived experiences from the families and patients they serve—better understand the realities of the daily struggles of many families on Medicaid.
Designed for the public good, the interactive website and free downloadable report, Reimagining Childhood Obesity, contain research findings, design recommendations, and a theory of change framework. The goal: provide practical, actionable guidelines for pediatricians, educators, healthcare organizations, and innovators to meet families and kids where they are and support them as they move toward a healthier future.
