Misperception Of Weight Status Research Articles

Understanding the Turkish adolescents' weight perception: A cross-sectional study.

Adolescence is regarded as a period in which adolescents go through a number of physical changes in appearance and a transition from childhood to adulthood. Throughout this transitional period, adolescents become more concerned with their size and weight. The aim of this study was to determine the self-perceived weights status of adolescents 11-19 years old. A cross-sectional study was conducted with a sample of 1459 students, aged 11-19 years, in Turkey. Anthropometric measurements of weight and height were measured with appropriate tools and adolescents' self-perception of weight status was assessed by the Figure Rating Scale. Nearly half of the adolescents had misperceptions about their weight status (49.6%). There was a significant association between body mass index (BMI) z-score categories and weight status misperception. Overall, the weight status misperception was more common among the girls than boys. Misperception of weight status in adolescent should take into account the following: development of intervention programs aimed at screening weight and weight perception, empowering young people to have accurate weight status perception, and raising awareness of the issue in school health professionals.

A SHORT REVIEW OF VALIDATED QUESTIONNAIRES FOR EVALUATING LEVELS OF PHYSICAL ACTIVITY IN CHILDREN AND ADOLESCENTS

Childhood and adolescent obesity becomes a worldwide health problem, as for the past years the prevalence of obesity amongst youngsters has reached very high levels. The increased levels of obesity at younger age rises concern at a global basis, therefore the prevalence of childhood obesity sets enormous pressure on healthcare system. Obesity is a complex trait influenced not only by genetic factors, but also by other such as: physical inactivity and unhealthy diet or overeating as well as weight status misperception. Some of the measures needed to overcome these factors is that the intervention programs used to prevent or combat obesity, must include assessment and correction of these factors, as well as monitoring their evolution over time. Questionnaires are efficient instruments that can be used for the evaluation of such parameters. This study aims to revise the scientific literature, from the last five years, to identify and centralize the most reliable and valid questionnaires created and used for the assessment of physical activity in children and adolescents.

In the Eye of the Beholder: Body Weight Misperceptions among African Americans Living in Kentucky

ABSTRACT Body weight status misperception, perceiving one’s self to be thinner than one’s body mass index (BMI), is growing in the United States. At risk for lifestyle-related disease, African Americans face more dire consequences with respect to this misperception than others. In a sample of African American Kentuckians, we found a moderate level of body weight status misperception. Educational attainment was the strongest predictor of body weight status misperception, with more education associated with less misperception. These findings suggest that health communication for African Americans should address body weight status misperception and be tailored for individuals’ level of educational attainment.

Parental feeding practices and child weight status in Bahraini families

Background: Home environment shapes the eating behavior of children thus their weight status. Parental feeding practices (restriction, pressure to eat, and monitoring) are behaviors taken by parents to manage a child’s dietary intake. Objectives: Raising awareness on the role of parental feeding practices in childhood obesity to allow for early parental intervention. Materials and Methods: In this cross-sectional study, a sample size of 332 children (6–11 years old) was chosen conveniently form eight health centers in Bahrain in August–September 2018. A translated Arabic version of the Child Feeding Questionnaire (CFQ) was filled by parents. Anthropometric measurements of children were conducted. Descriptive statistics were used to describe mean item scores of the CFQ. Correlation tests determined relationships between parental feeding practices and body mass index (BMI)-for-age Z-scores. Chi-square statistics and independent sample t-tests compared parental perception of child weight and feeding practices. Results: The prevalence of obesity among Bahraini children aged 6–11 years was estimated to be 16.87% and overweight was 14.46%. Obesity was more prevalent among males, while overweight in females. The predominant feeding practice was monitoring followed by restriction. Child BMI was negatively correlated with pressure to eat and positively correlated with restriction in males. No significant correlation was found with monitoring. About 56.0% of parents were found to misperceive their child weight status, 50.9% underestimated the weight status. Conclusion: Childhood obesity has reached alarming levels, which may persist due to the parental misperception of child weight status. Avoiding restrictive feeding could limit this problem.

MON-114 Patient Perceptions of Obesity: African American vs. Caucasian Adults in an Urban Endocrinology Clinic

Introduction: The prevalence of obesity in the U.S. is highest in non-Hispanic black adults (38.4%) and Hispanic adults (32.6%) compared to non-Hispanic white adults (28.6%). Despite known racial disparities in obesity, not much is known about why these differences exist.Objective: This study evaluated awareness of obesity, perceptions of obesity management, and barriers to adequate care in African American and Caucasian patients.Methods: A 48-question survey was administered in 2018–2019 to an urban Endocrinology clinic’s adult patients with a body-mass index (BMI) ≥ 30 kg/m2. Chi-squared or Fisher’s exact tests were used to compare variables between groups.Results: Of 137 respondents, 98 were African American and 39 were Caucasian. Most respondents were female (59–63.9%), had some college education (61.2–71.8%), and an annual income ≤ $50,000 (51.3–63.2%). Comorbidities included hypertension (64–66%), diabetes (73–79%), and arthritis (47–51%). Significantly more Caucasians than African Americans were aware of their BMI (65.8% vs 40%, p=0.0071). Both African Americans and Caucasians perceived their weight to be less than their actual BMI (African Americans: 23.2% perceived “obese” vs. 72.5% BMI 30–39.9 kg/m2 [p<0.001] and 6.3% perceived “extremely obese” vs. 27.6% BMI > 40 kg/m2 [p<0.001]; Caucasians: 37.8% perceived “obese” vs. 66.6% BMI 30–39.9 kg/m2 [p=0.02] and 8.1% perceived “extremely obese” vs. 33.3% BMI > 40 kg/m2 [p=0.01]). Over 90% in both groups agreed that obesity is related to hypertension, diabetes, heart disease, and early death, and 100% considered obesity treatable. Most (72.2–73.7%) recalled their health care provider (HCP) discussing obesity in the past year. Weight loss options discussed were similar between groups. Most discussed diet (70–82%) and exercise (59–62.2%) with HCPs, but few discussed formal weight loss programs (16.3–20.5%), anti-obesity medications (10%), or bariatric surgery (7–10.3%). Barriers were similar for both groups. Top barriers to diet were cost and lack of time and knowledge. Barriers to exercise were lack of time and inability to exercise. Top reasons for not discussing anti-obesity medications and bariatric surgery included concern for side effects or complications, lack of knowledge of the medications/procedures, and cost with surgery.Conclusions: This study found similar perceptions of obesity management among African American and Caucasian patients with obesity. Despite excellent awareness of obesity as a health problem, decreased awareness of BMI and misperception of weight status were present in both groups. Discussion of diet and exercise was frequent, but discussion of formal weight loss programs, anti-obesity medications, and bariatric surgery was poor. These findings suggest a need for greater patient education and discussion of BMI and treatment beyond diet and exercise for patients with obesity.

Factors Influencing Parents' and Children's Misperception of Children's Weight Status: a Systematic Review of Current Research.

Misperception of children's weight status is prevalent among parents and children themselves and may impact parents' and children's health behaviors. This study was conducted in order to provide a descriptive systematic review of research on factors influencing parents' and children's misperceptions of children's weight status published in the past 5 years. Factors studied most often in relation to parents' and children's misperception included children's weight status, gender, and age, as well as parents' weight status, parental education levels and socioeconomic status, and ethnicity. Most determinants that were found to have a significant influence on misperception in parents also did in children. The literature on misperception of children's weight status is extensive. Most determinants assessed in included studies were known determinants of childhood obesity. Further research should be directed toward better understanding the impact of weight status perception (whether it is accurate or not) on health behaviors and weight gain over time.

Body Weight Misperception and Psychological Distress Among Children and Adolescents: The CASPIAN-V Study.

ObjectivesMisperception of weight status is a risk factor that affects psychological health. The aim of this study was to evaluate the association between weight misperception patterns and psychological distress among Iranian children and adolescents.MethodsThis was a cross-sectional nationwide study where data was collected from 14,440 students, aged 7–18 years who participated in the national school-based surveillance program (CASPIAN-V). The students’ weight perception and psychological distress were assessed by validated questionnaires. Weight misperception was classified as misperception of being either underweight or overweight with respect to actual weight.ResultsThe rate of weight misperception in all study participants was 59.1%. In groups with a perception of being underweight or overweight, the risks of worthlessness, being worried, experiencing aggression, insomnia, or depression, were significantly higher than groups with an accurate weight perception (p < 0.05). The risk of anxiety in girls of normal weight who perceived themselves as underweight, decreased by 57% compared to girls with an accurate weight perception (OR: 0.43; 95% CI, 0.28–0.66).ConclusionWeight misperception is highly prevalent among Iranian children and adolescents and is associated with their psychological health status. Appropriate education intervention needs to be developed to improve the children and adolescents’ perception of their body weight status.

Is social exposure to obesity associated with weight status misperception? Assessing Australians ability to identify overweight and obesity

IntroductionOverweight and obesity prevalence has increased significantly over the past two decades, currently impacting greater than 60% of Australians. It is unclear if a social perception of a healthy weight has been obscured by the increase in prevalence and thus has become inconsistent with the medical definitions.MethodsAn electronic questionnaire was distributed via email and social media using the authors’ informal networks. Australian adults were eligible to participate. Participants were asked to categorise their own body size using medically accepted words and previously published silhouettes, before identifying underweight, healthy weight, overweight or obesity in a series ofsilhouettes.ResultsEight hundred six questionnaires were completed, a majority of participants had attained a high level of education and were employed female health professionals. Under half the studied population had a Body Mass Index (BMI) corresponding to overweight or obese categories (n = 349, 47%). Accuracy in self-perceived weight status using medicalised words was higher among respondents with BMI corresponding to the healthy weight category (n = 311, 85%) and overweight category (n = 133, 74%) than for respondents with BMI corresponding to obesity (n = 79, 45%) or underweight (n = 5, 31%). A majority of respondents were able to accurately self-perceive their weight status using silhouettes (n = 469, 70%). Females were significantly more likely to be accurate in their self-perception than males, using both medicalised words (p = < 0.001) and silhouettes (p = 0.045). Respondents with a BMI corresponding to the obese category were significantly more likely to be accurate with weight status self-perception using silhouettes than words (87% versus 46% respectively, p = < 0.001). Less than half (41%) of respondents accurately perceived silhouettes corresponding to an overweight BMI and less than one in ten respondents (9%) accurately perceived the lower limit of the silhouettes corresponding to an obese BMI.ConclusionsRepondents were challenged to accurately perceive silhouettes corresponding to an obese BMI in themselves and others. Weight status misperception was more likely to exist among those with a BMI less than 18.5 or 30 or more (underweight BMI and obese BMI). Accuracy decreased as BMI increased. Respondents with a BMI in the obese category were significantly more likely to accurately self-perceive their weight status using silhouettes than medicalised words. Silhouettes may act as an effective visual cue in initiating weight related discussions.

The role of drive for thinness in the association between weight status misperception and disordered eating

Weight status misperception is related to disordered eating outcomes, but little research has explored the differential impacts of misperception directionality, nor factors that explain these relationships. Self-Discrepancy Theory applied to body image gives a framework to how weight status over-perception may prompt a drive for thinness, which in turn may be important in the development of disordered eating cognitions and behaviors. AimsTo that end, the current study tested whether drive for thinness may account for the association between direction of weight status misperception and disordered eating behaviors. MethodsYoung adults (N = 522) completed measures identifying weight status perception (accurate, under-, and over-perception), drive for thinness, and disordered eating attitudes and behaviors (appearance satisfaction, restrained, uncontrolled, and emotional eating). Indirect effect models with drive for thinness entered as the intervening variable were estimated for each outcome. ResultsDrive for thinness accounted for the associations between weight status misperception and all outcomes. In general, compared to either accurate or under-perception, over-perception of weight status was associated with more disordered eating attitudes and behaviors via higher drive for thinness. ConclusionsConsistent with Self-Discrepancy Theory, drive for thinness emerged as a possible mechanism of the association between weight status misperception and disordered eating outcomes. Findings suggest potential utility in targeting drive for thinness, as opposed to accuracy of weight status perception, for prevention of disordered eating attitudes and behaviors, including those that may contribute to weight gain.

Perceived Weight Status Among College Students and Its Relationship with Life Satisfaction (FS10-08-19)

ObjectivesAs mistaken body weight perceptions have been linked to less healthy diet and activity behaviors, accurate weight perception may help individuals set appropriate, health-related weight goals. However, some data link poor weight perception with negative mental health. The purpose of this study is to examine the prevalence of body weight misperception and self-reported life satisfaction among undergraduate college students. MethodsData were collected from undergraduate students (18–24 years) participating in an on-going cross-sectional health survey at a midsize, northeastern university between 2010–18 (n = 3921). Students self-reported their described weight status and life satisfaction via online questionnaire; body composition was assessed via bioelectrical impedance in a fasted state. Proportional differences between men and women were evaluated using chi-square analyses. ResultsMore than a third (35.9%) of students misperceived their weight status. Among men (n = 1190), 31.7% misperceived their weight status. Among women (n = 2731), 37.6% misperceived their weight status. Compared with men, women had a higher prevalence of overestimating their weight status (31.7 vs. 11.1%, P < 0.01). Compared with women, men had a higher prevalence of underestimating weight status (20.7 vs. 5.9%, P < 0.01). No significant differences in life satisfaction were observed among individuals who correctly perceive their weight status versus those who misperceived. ConclusionsOur results show a high prevalence of undergraduate college students who misperceive their weight status; however, misperception was not associated with differences in life satisfaction. As misperception of weight status differed between genders, targeted interventions related to the promotion of healthy weight may consider sex-specific messaging in college students. Funding SourcesNew Hampshire Agriculture Experiment Station and USDA National Institute of Food and Agriculture Hatch Project 1010738.

Weight status perception and weight loss intention among urban youth

AimWe explored associations of weight perception with measured weight status and weight loss intention among urban youth. MethodsThis community surveillance project included 317 youth (10–19 years, 64% black) who answered YRBSS questions and underwent measurements of height and weight. ResultsWeight misperception was observed among 47% of participants; 41% underestimated and 6% overestimated their weight status. Among youth with overweight and obesity, however, 72% misperceived their weight status; those with accurate perception were more likely to report trying to lose weight. ConclusionAddressing weight status misperceptions may be essential when advocating lifestyle behavior change to promote healthful body weight among youth.

Body mass index as a moderator of the association between weight status misperception and disordered eating behaviors

Weight status under-perception is protective against disordered eating behaviors and weight gain; however, it is unclear whether under-perception may confer protection across all weight classes. This work explored body mass index as a moderator of the association between weight status perception accuracy and disordered eating behaviors among adults with overweight or obesity. A total of 572 adults (58.7% female; age M = 39.50, SD = 11.57) with overweight or obesity (body mass index M = 31.50, SD = 6.24) completed a series of online questionnaires assessing uncontrolled, emotional, and restrained eating, eating disorder symptoms, weight status perception, and demographics. Controlling for race/ethnicity, age, and sex, linear and negative binomial regressions were used to test hypotheses. Compared to accurate weight status perception, under-perception was associated with less uncontrolled (p = .003) and restrained eating (p = .002). Under-perception was particularly protective against emotional eating (p = .022) and eating disorder symptoms (p = .017) for individuals of overweight or Class I obesity. In general, weight status under-perception was associated with fewer disordered eating behaviors. The protective effects of under-perception of weight status may be maximized for individuals of overweight or Class I obesity statuses.

Normalization of Plus Size and the Danger of Unseen Overweight and Obesity in England

ObjectiveThis study aimed to investigate trends and sociodemographic factors underlying weight misperception in adults with overweight and obesity in England.MethodsThis study used descriptive and logistic regression analyses based on a pooled nationally representative cross‐sectional survey, Health Survey for England, for the years 1997, 1998, 2002, 2014, and 2015 of individuals with BMI ≥ 25 (n = 23,459). The main outcomes were (1) weight misperception and (2) weight‐loss attempts as well as the associations with demographic and socioeconomic characteristics and health status.ResultsThe proportion of individuals with overweight and obesity misperceiving their weight status increased over time between 1997 and 2015 (37% to 40% in men; 17% to 19% in women). There were socioeconomic disparities in the misperception of weight status, with lower‐educated individuals from poorer‐income households and members of minority ethnic groups being more likely to underestimate their weight. Those underestimating their overweight and obesity status were 85% less likely to try to lose weight compared with people who accurately identified their weight status.ConclusionsThe upward trend in underassessment of overweight and obesity status in England is possibly a result of the normalization of overweight and obesity. Obesity prevention programs need to consider differential sociodemographic characteristics associated with underassessment of weight status.

Trends and correlates of unhealthy dieting behaviours among adolescents in the United States, 1999\u20132013

BackgroundThe increase in adiposity problems among United States adolescents has been accompanied by persistently high prevalence of unhealthy dieting behaviours (UDBs) such as fasting, taking diet pills/powders/liquids, and vomiting/taking laxatives. This study aimed to examine the associations of self-perceptions of weight status, weight change intentions (WCIs) and UDBs with sex, age and race, as well as trends of UDBs in American adolescents across the weight spectrum.MethodsData come from the biennial cross-sectional, school-based surveys, the Youth Risk Behaviour Surveillance System (1999–2013, n = 113,542). The outcome measures were the self-reported UDBs: fasting for 24 h or more; taking diet pills/powders/liquids; and vomiting/taking laxatives. Sex-stratified logistic regressions assessed relationships between weight status misperceptions across all weight statuses, race and WCIs with UDBs. Differential trends between races were assessed using race*year interaction terms.ResultsIn males, all non-White races had higher odds of fasting and vomiting/taking laxatives than Whites (except fasting in Hispanic/Latinos), with Adjusted Odds Ratios (AORs) between 1.44 and 2.07. In females, Black/African Americans and Hispanic/Latinos had lower odds of taking diet pills/powders/liquids compared to Whites (AORs 0.50 and 0.78 respectively). Racial disparities persisted throughout the study period. Prevalence of fasting and vomiting/taking laxatives did not change between 1999 and 2013 for all races, while taking diet pills/powders/liquids decreased. Compared to individuals of normal weight who were accurate weight status perceivers, individuals of almost all other combinations of weight status and weight status perception had significantly higher odds of displaying any UDB outcome. Overestimation of weight status was found to be the strongest determinant of UDBs. Compared to individuals endorsing "not wanting to do anything" about their weight, individuals endorsing all other WCIs (including wanting to gain weight) also showed significantly higher odds for every UDB outcome, with wanting to lose weight having AORs of the greatest magnitudes.ConclusionsPrevalence of UDBs is persistently high, and highest among females across all racial groups. UDBs may elevate undesired weight gain and weight loss in individuals who are obese/overweight and underweight respectively. Further research into weight status perceptions among adolescents may inform efforts to reduce UDBs.

Factors associated with parental underestimation of child's weight status

ObjectiveThe aim of this study was to examine the prevalence of parental misperception of child weight status, and identify socioeconomic, anthropometric, behavioral and dietary factors associated with underestimation. MethodCross‐sectional study. Data was collected in 14 Brazilian private schools. Parents of children aged 2–8 years (n=976) completed a self‐reported questionnaire assessing their perception of their child's weight status, and sociodemographic, anthropometric, behavioral and dietary information. To measure the agreement between parental perception about child weight status and actual child weight status, the Kappa coefficient was estimated, and to investigate associations between parental underestimation and independent variables, chi‐squared tests were performed, followed by multiple logistic regression, considering p≤0.05 for statistical significance. ResultsOverall, 48.05% of the parents incorrectly classified their child's weight. Specifically, 45.08% underestimated their child's weight status, with just 3% of parents overestimating. Children with higher body mass index (OR=2.03; p<0.001) and boys (OR=1.70; p<0.001) were more likely to have their weight status underestimated by parents. ConclusionSince awareness of weight problems is essential for prevention and treatment, clinical practitioners should help parents at high risk of misperception to correctly evaluate their child's weight status.

Factors that Influence Parental Misperception of Their Child's Actual Weight Status in South Carolina.

Objectives Studies suggest that parents tend to misperceive their child's actual weight status and typically underestimate their child's weight. Since few studies examine the factors that influence parental misperception, this study aims to assess the influence of parent and child factors with parental misperception of their child's actual weight status who were either at their recommended weight or overweight/obese in South Carolina in 2013 and 2014. Methods Secondary data were obtained from the Behavioral Risk Factor Surveillance System (BRFSS) and the Children's Health Assessment Survey (CHAS) in 2013 and 2014 in SC. Parental misperception of child's actual weight status was measured by comparing parental perception to their child's actual weightstatus measured via BMI. Logistic regression was conducted to assess the association between parental and child factors with parental misperception of child's weight status. Results In the adjusted multivariate analysis, only child's age was significantly and positively associated with parental misperception of their child's actual weight status. Conclusions for Practice This cross sectional analysis showed an association between child's age and parental misperception of child's actual weight status. It is essential to educate parents about their children's weight status, especially among young children.

Overweight in children and its perception by parents: cross-sectional observation in a general pediatric outpatient clinic

BackgroundChildhood overweight is a growing problem in industrialized countries. Parents play a major role in the development and the treatment of overweight in their children. A key factor here is the perception of their child’s weight status. As we know of other studies, parental perception of children’s weight status is very poor. This study aimed to determine factors associated with childhood overweight and parental misperception of weight status. The height and weight of children, as reported by parents were compared with measured data.MethodsThe study was conducted at a general pediatric outpatient clinic in Vienna, Austria. A total of 600 children (aged 0–14 years) participated in the study. Collection of data was performed by means of a questionnaire comprising items relating to parental weight and social demographics. The parents were also asked to indicate their children’s weight and height, as well as the estimated weight status. Children were weighed and measured and BMI was calculated, allowing a comparison of estimated values and weight categories with the measured data.ResultsParental BMI, parental weight and a higher birth weight were identified as factors associated with childhood overweight. No association with the parents’ educational status or citizenship could be proven. We compared parents’ estimations of weight and height of their children with measured data. Here we found, that parental estimated values often differ from measured data. Using only parental estimated data to define weight status leads to misclassifications. It could be seen that parents of overweight children tend to underestimate the weight status of their children, compared to parents of children with normal weight.ConclusionsPediatricians should bear in mind that parental assessment often differs from the measured weight of their children. Hence children should be weighed and measured regularly to prevent them from becoming overweight. This is of particular importance in children with higher birth weight and children of overweight parents.Trial registrationStudy was not registered. The study was approved by the Ethic committee of the city of Vienna. (EK 13–146-VK).

Longitudinal impact of weight misperception and intent to change weight on body mass index of adolescents and young adults with overweight or obesity

ObjectiveAccurate perception of one's weight status is believed to be necessary to motivate weight loss intention and subsequent weight loss among those with overweight/obesity. This proposed pathway, however, is understudied in longitudinal research. This study examined the indirect effect of weight change intention on the relationship between weight status perception and BMI change among adolescents with overweight/obesity. MethodsParticipants included 2664 adolescents with overweight/obesity (52% female) from the National Longitudinal Study of Adolescent Health. Longitudinal associations between Wave II weight status perception (accurate versus misperception) and intent to change weight (i.e., gain, lose, stay the same) on BMI change (Wave II–Wave IV) were examined using multiple linear regression. Indirect effects of weight change intention were investigated using the Monte Carlo method. Analyses were stratified by gender. ResultsAccurate perceivers (81.0% female; 60.1% male) were more likely than misperceivers (i.e., perception of “about the right weight”) to report weight loss intention (p<0.001). Among females, weight status misperception and weight loss intention individually were associated with smaller (β=−1.37, 95% CI [−2.64, −0.10]) and greater (β=1.18, 95% CI [0.11, 2.25]) BMI gains, respectively. Among males, fully adjusted models suggested that weight status misperception was associated with significantly smaller gains in BMI over time (β=−1.51, 95% CI [−2.38, −0.63]). Weight change intention did not emerge as an indirect effect for either gender. ConclusionsAlthough weight status misperception was protective against weight gain, weight change intention did not provide an explanation for this relationship.

Factors associated with parental underestimation of child's weight status

ObjectiveThe aim of this study was to examine the prevalence of parental misperception of child weight status, and identify socioeconomic, anthropometric, behavioral and dietary factors associated with underestimation. MethodCross-sectional study. Data was collected in 14 Brazilian private schools. Parents of children aged 2–8 years (n=976) completed a self-reported questionnaire assessing their perception of their child's weight status, and sociodemographic, anthropometric, behavioral and dietary information. To measure the agreement between parental perception about child weight status and actual child weight status, the Kappa coefficient was estimated, and to investigate associations between parental underestimation and independent variables, chi-squared tests were performed, followed by multiple logistic regression, considering p≤0.05 for statistical significance. ResultsOverall, 48.05% of the parents incorrectly classified their child's weight. Specifically, 45.08% underestimated their child's weight status, with just 3% of parents overestimating. Children with higher body mass index (OR=2.03; p<0.001) and boys (OR=1.70; p<0.001) were more likely to have their weight status underestimated by parents. ConclusionSince awareness of weight problems is essential for prevention and treatment, clinical practitioners should help parents at high risk of misperception to correctly evaluate their child's weight status.

Parents' Underestimations of Child Weight: Implications for Obesity Prevention

PurposeObesity prevention efforts may be ineffective if parents lack awareness of their children's overweight status.This study examined the factors that predicted parents' underestimation of child weight status. Design and MethodsUsing a cross sectional design, researchers recruited children and parents in a local children's museum. Parents completed a demographic questionnaire, the Newest Vital Sign, and the Child Body Image Scale. Children's height and weight were measured to calculate child BMI. Random effects modeling examined the association between predictor variables (parent race/ethnicity, income, education, and health literacy, and child BMI percentile, gender, and age) and the dependent variable, parent underestimation of child weight status. ResultsParticipants included 160 parents (213 children aged 7–12years) representing a racially and ethnically diverse sample who were affluent, educated, and with 36.6% of parents assessed with limited health literacy. Although 45.1% of children were overweight/obese, only 7.5% of parents chose this weight status; 80% of parents underestimated the weight of their normal weight children, 96% underestimated their overweight children, and 72% underestimated their obese children. Parents were more likely to underestimate weight of older children and those under 81st percentile of BMI. No other predictors were significant. ConclusionsParent underestimation of child weight status appears to be a widespread phenomenon in this sample, regardless of race, ethnicity, income, education, and health literacy. Practice ImplicationsThe consistent underestimation of child weight suggests that parents' misperception of weight status represents a critical pathway for intervention. Methods to improve parents' perception of child weight need be developed and tested.