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Many parents fail to recognize signs of childhood obesity
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Parents of children with obesity may be unable to recognize that their child is overweight unless they are at extreme levels of obesity, according to research in the British Journal of General Practice.
Parents were more likely to underestimate a child’s weight if the child was black or South Asian, male, from a deprived background or older (aged 10 to 11 years).
“If parents are unable to accurately classify their own child’s weight, they may not be willing or motivated to enact changes to the child’s environment that promote healthy weight maintenance,” the researchers wrote.
James Black, MD, with the department of noncommunicable disease epidemiology at the London School of Hygiene and Tropical Medicine, and colleagues at other institutions studied 2,976 children participating in the U.K. National Child Measurement Programme (NCMP), which measures the heights and weights of all children at baseline (aged 4 to 5 years) and year 6 (aged 10 to 11 years) at state schools in England. The data come from the 2010-2011 school year and include children from five primary care trusts (PCTs).
Parents completed questionnaires the day of their child’s NCMP measurement but before they received weight feedback. Parents stated whether they believed their child was underweight, healthy weight, overweight or very overweight. PCT records provided the child’s age, sex, ethnic group, school year and nurse-measured weight and height.
In total, 31% of parents (n = 915) underestimated and less than 1% (n = 25) overestimated their child’s weight status. Four parents described their child as being very overweight, despite 369 being very overweight according to the BMI cutoffs.
According to government guidelines, children are classified as “overweight” at the 85th percentile and “very overweight” (or obese) at the 95th percentile. For a child with a BMI at the 98th percentile (very overweight), there was an 80% chance a parent would classify that child as healthy weight (95% CI, 76-83). However, for a child with a BMI at the 99.7th percentile, a parent had an equal chance of classifying the child as healthy or overweight, according to research.
The study also found that parents were more likely to underestimate a boy’s weight status, potentially highlighting sex-specific norms for body appearance, according to researchers.
The study is the first to quantify the disparity between objective cutoffs and cutoffs derived from parental perceptions.
“This discrepancy in perceived weight status is important for policymakers and clinicians to consider in their approaches to obesity prevention,” the researchers wrote. “Weight management interventions targeted at the parents of overweight children are unlikely to register with the intended audience if few parents consider their child to be overweight.” – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.
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