Abstract

Background Childhood overweight and obesity are prevalent in Chile and globally. Health care responses typically emphasise biomedical and risk-focused approaches, with limited attention to children’s own perspectives. Objective This study explored how children clinically classified as overweight or obese understand health, growth and weight within health contexts. Methods Participants were recruited from primary care clinics in two municipalities in Santiago, Chile. Semi-structured online interviews were conducted with 18 children aged 10–12 years during COVID-19 restrictions, incorporating visual tools such as body silhouettes and body mapping to facilitate discussion. Data were analysed using reflexive thematic analysis. Results Three major themes were identified: Translating Fatness: everyday words and the softening of body labels; Body shapes, shame, and the making of ‘unhealthy’ bodies; and Making Sense of Measurement: Receiving, Interpreting and Negotiating Medical Labels. Conclusions The study highlights that children actively interpret and negotiate weight-related messages, drawing on emotional, social, and cultural frames rather than biomedical ones. Clinical encounters can heighten body awareness and stigma. Clinical practice should prioritise non-stigmatising communication, value children’s perspectives, and adopt approaches that support wellbeing during growth and identity development.