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Parents held false view of child's obesity, despite BMI percentile

Issue: June 2012

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Obese children’s parents or caregivers had an inaccurate perception of their child’s weight status, according to data presented at the 2012 Pediatric Academic Societies Annual Meeting.

Naveen K. Uli, MD, director of the Healthy Kids & Healthy Weight Program at UH Case Medical Center in Ohio, and colleagues conducted a comprehensive evaluation of the parents/caregivers of 422 children aged 7 to 17 years (62% female; 55% white).

According to data, the average BMI-for-age percentile was 98.8 (standard deviation=1.4; range=88.2-99.9), with 98.1% obese (BMI ≥95th percentile) and 1.9% overweight (BMI=85th-94th percentile). Using a 5-point Likert scale (ranging from very underweight to very overweight), parents were asked to categorize their child’s weight status.

Before the study, almost half of parents categorized their obese children in a lower weight category (n=193; 46.6%). Additionally, those who held accurate viewpoints had older children (147 months vs. 140 months; P=.06) with higher BMI percentiles than those with false viewpoints (P<.01). However, children who were categorized in a lower category by an inaccurate parent showed marked reductions in their BMI throughout the 12-week intervention program vs. children whose parents had a correct perception of their weight status (P=.05).

After an adjusted model, child age became an important factor in predicting decreases in BMI percentile (P=.05), and certainty of weight viewpoint was reduced (P=.08). The parent and child’s ethnicity, sex and marital status provided no significance in terms of differences of accuracy.

According to the data, many caregivers of obese children entering a weight-loss program continue to struggle with a false view of their child’s weight status. Challenges remain as to whether parental perception is influenced by the child’s pediatrician, or if it is simply the parent’s ability to accept their child’s weight status.