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Parents Often Misperceive Their Obese Children As “About the Right Weight”

New Study Led by NYU Langone Medical Center Examines Several Contributing Factors Including Race, Income & Peer Comparisons

Although rates of childhood obesity have risen over the last several decades, a vast majority of parents perceive their kids as “about the right weight,” according to new research led by NYU Langone Medical Center.

The research findings appear online in the journal Childhood Obesity, and also included researchers from Georgia Southern University and Fudan University in Shanghai.

The authors believe it is the first study to examine the lack of change over time of parents’ perception of their preschool child’s weight status. The results are important, they say, because parents with accurate perceptions of their children’s weight are more likely to implement behavior changes that could lead to weight reduction.

Researchers analyzed data from the National Health and Nutrition Examination Survey (NHANES), conducted by the Centers for Disease Control and Prevention, which uses physical examinations and interviews to assess the health and nutritional status of adults and children in the U.S. They studied two groups of children over two time periods: 3,839 children from 1988–94, and 3,151 children from 2007–12.

In these surveys, parents were asked whether they considered their child, ages two to five years old, to be overweight, underweight, or just about the right weight. 

Nearly all parents of overweight boys from the first study group perceived their sons as ‘‘about the right weight’’ (97 percent), with a very similar result from the second study group (95 percent). 

Parents with overweight girls did only slightly better; approximately 88 percent in the first study perceived their daughters as “about the right weight” and 93 percent in the more recent survey. 

What was particularly alarming, the researchers point out, is that the children in the second study group were significantly more overweight than the children in the first study group, yet the parents’ perception of their children remained relatively unchanged. 

“The results are consistent with past studies in which a considerably high number of parents incorrectly perceived their overweight/obese preschool child as being ‘just about the right weight’,” says Dustin Duncan, ScD, lead author of the study and an assistant professor in the Department of Population Health at NYU Langone and affiliated faculty member at NYU’s Global Institute of Public Health.   

In both study groups, parents’ misperception of their child being “about the right weight” was most pronounced among African American families. In addition, as family income increased, parents were more inclined to correctly perceive their children as overweight or obese. "This was especially concerning because African-American and low-income children in the U.S. have the highest rates of obesity," Dr. Duncan said. 

Dr. Duncan also points out that parents often compare their own child to other kids in deciding if their child is overweight. Instead of using science-backed growth charts as the standard with which to compare their child, parents are possibly looking to peers as the standard, he says. “Research examining social comparison theory suggests that individuals evaluate themselves in relation to others, rather than against an absolute scale.”

The authors also suggest that ineffective communication between parents and the medical community might explain a substantial part of the misperception. Few parents were able to understand the growth charts and implications the data presented.

Jian Zhang, MD, DrPH, senior author of the study and an associate professor of epidemiology at Georgia Southern University, emphasizes that parental recognition of their child’s overweight status is paramount to obesity prevention efforts.

Such recognition of their child’s overweight status and of the associated health risks are driving forces that should motivate parents to act on their children’s behalf, he says. “We need effective strategies to encourage clinician discussions with parents about appropriate weight for their child. This will be critical for childhood weight management and obesity prevention.”

Besides Drs. Duncan and Zhang, Andrew R. Hansen, DrPH, of the Department of Community Health Behavior and Education in the Jiann-Ping Hsu College of Public at Georgia Southern University, Wei Wang, MD, PhD, and Fei Yan, MD, PhD, of the Department of Social Medicine and Biostatistics at the Fudan University School of Public Health, were involved in the study.

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