Is my kid out of size? Indian mothers' desirability bias in evaluation of their children's weight.

Abstract

To quantify mothers' social desirability bias with respect to their children's weight in a cross-regional Indian setting. The OBEY-AD was a cross-sectional study which has been realized in 7 Indian cities (Bengaluru, Mumbai, Chennai, Hyderabad, Kolkata, New Delhi and Surat), enroling 1,680 children aged 3-11 y of which 50% were females. Children's BMI scores were computed, standardized according to WHO growth charts and categorized as Normal, Overweight, Obese and Underweight. Mothers were asked to judge the weight status of their children through an iconographic test, indicating the shape, which better mirrors the size of their kids. Socio-demographic data, especially employment, income and education, was accessed by administrating a cross-sectional questionnaire to the mothers, involved for the study. Overall, 369 children resulted as obese or overweight (23.5%). Out of them, 75% (278) were not recognized as such by their mothers. Such figures range from up to 76% in Chennai and Surat down to 72% in Hyderabad, Kolkata, New Delhi and Mumbai. Overall agreement between perceived and desired weight status of children was very poor (p < 0.001). Surprisingly, overall 10% of overweight/obese children were considered as even too lean by their mothers. Misperception of children's weight status seemed to be significantly related to urban differences and socio-economic status. This study quantifies the extent of the so-called social desirability bias, namely mother's unconscious attitude to adapt empirical evidence to more culturally legitimized ideal-types of what their children's weight status is expected to be. Its association with westernized representations of leanness as evaluation criteria for beauty has important policy implications.