Parental perception of children's weight in a paediatric primary care setting

Department of Pediatrics, University of Wisconsin Children's Hospital, Madison, WI 53792, USA.
Child Care Health and Development (Impact Factor: 1.69). 12/2007; 33(6):738-43. DOI: 10.1111/j.1365-2214.2007.00753.x
Source: PubMed


To determine how parents of overweight children perceived their children's weight status compared with actual body mass index (BMI).
This descriptive, cross-sectional study assessed parental perception of and concern about weight, diet and physical activity of 3-12-year-olds. BMI values >or=85th and <95th percentile and >or=95th percentile were considered at risk for overweight and overweight respectively. Differences between groups were tested with chi-squared analyses or Fishers exact test as appropriate and further explored using logistic regression analysis.
Questionnaires were completed at 612 health maintenance visits (278 girls). Overall, 15% of both boys and girls were at risk for overweight and 22% of boys and 24% of girls were overweight. Forty-nine per cent of parents recognized their overweight children as overweight. Perceptions were more often correct for parents of girls than boys (63% versus 36%, P < 0.001) and for older compared with younger children (61.7% versus 17.5%, P < 0.001).
Parents of overweight children frequently did not perceive their children as exceeding healthy weight standards. Targeting parental perception as a point of intervention is necessary.

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    • "Comparable results have been reported for samples including both children and adolescents with overweight or obesity [13], although it has been suggested that the accuracy of parental weight perception increases with the age of the offspring [14]. There are mixed findings with regard to the offspring’s gender, as some studies show that overweight boys are more likely to be underestimated than girls [15], while others show either the opposite [16] or no gender effect [17]. The likelihood of parents’ underestimation seem to increase with higher Body Mass Index (BMI) of the offspring [16], and this may increase the risk of maintaining unhealthy eating patterns for children and youth who are already at the upper levels of the weight distribution. "
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    ABSTRACT: An accurate weight perception has been associated with motivation to change eating habits in the case of under- or overweight. However, recent studies have reported frequent misperceptions among parents and their offspring, both in the form of under- and overestimation of weight status. The aim of the present study was to investigate weight perception accuracy among parents of young adolescents in relation to reports on disturbed eating patterns and mental health problems. Weight perception accuracy was assessed among parents of young adolescents (N = 5,781, aged 11 - 13 years) who participated in the ongoing Bergen Child Study (BCS). Parental weight perception was classified in overestimation, underestimation and accurate. Other measures included demographic variables, the parents' evaluations of disturbed eating patterns and mental health problems among their offspring as well as the adolescents' own weight perception accuracy. The parents accurately perceived more than 80% of normal weight adolescents, but nearly 60% of the underweight adolescents were overestimated, and a substantial proportion of overweight girls (34. 8%) and boys (12.8%) were underestimated. In general, parents who were aware of deviations from average weight in their child also reported higher levels of disturbed eating patterns, emotional problems, and behavioral problems. After controlling for demographic factors, the risk of parental over- and underestimation was significantly predicted by weight status, the adolescents' weight perception accuracy as well as disturbed eating patterns reported by the parents (p < .05). Adolescents with under- or overweight proved most likely to be misperceived by their parents in this study. The pattern of perceptually correcting deviations from normal weight was interpreted as a positivity bias among the parents. These results suggest that weight perception accuracy should be targeted in family-focused interventions in order to strengthen adequate weight control among young adolescents.
    Journal of Eating Disorders 03/2014; 2(1):9. DOI:10.1186/2050-2974-2-9
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    • "Previous studies into the effectiveness of weight feedback have shown that, despite some improvement in parental recognition of their child being overweight after receiving weight feedback, parents remain largely unaware of either weight status or the associated health risks, and minimal changes in lifestyle behaviours have been observed (Grimmett et al., 2008; West et al., 2008). Several studies have investigated demographic predictors of parental recognition of overweight children but there is little consistency in the findings, except for a tendency for parents of older children to be more accurate (Rhee et al., 2005; Eckstein et al., 2006; Wald et al., 2007). Few studies have looked at the reasons why parents do not recognise their child as being overweight or perceive this as a health risk. "
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    ABSTRACT: Background The present study aimed to explore parental perceptions of overweight children and associated health risks after receiving National Child Measurement Programme (NCMP) weight feedback. Methods Fifty-two parents of overweight and obese children aged 4–5 years and 10–11 years enrolled in the NCMP programme in England in 2010–2011 participated in qualitative, semi-structured interviews about their perceptions of their child's weight and health risk after receiving weight feedback. Interviews were audio tape recorded and were conducted either by telephone (n = 9) or in the respondents’ homes (n = 41). Interviews were transcribed verbatim and analysed using interpretative thematic analysis. ResultsParents who received NCMP written feedback informing them that their child was overweight disregarded the results because they viewed ‘health and happiness as being more important than weight’. The feedback was viewed as less credible because it did not consider the individual child's lifestyle. ‘Broad definitions of healthy’ were described that did not include weight, such as reference to the child having good emotional and physical health and a healthy diet. Parents attributed weight to ‘inherited/acquired factors’ such as genetics or puppy fat, or did not regard their child's ‘appearance’ as reflecting being overweight. ‘Cultural influence’ also meant that being overweight was not viewed negatively by some non-white parents. Conclusions After receiving written weight feedback, parents use methods other than actual weight when evaluating their child's weight status and health risks. Parents’ conceptions of health and weight should be considered when communicating with parents, with the aim of bridging the gap between parental recognition of being overweight and subsequent behaviour change.
    Journal of Human Nutrition and Dietetics 02/2014; 28(1). DOI:10.1111/jhn.12217 · 1.99 Impact Factor
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    • "Cross-sectional surveys 635 87% of parents of overweight children disagreed that their child was overweight Netherlands 2–4 Carnell et al. (2005) Determine parents' perceptions of their child's weight compared to measured weight 564 98.1% of parents of overweight children and 82.9% of parents of obese children did not perceive him/her as overweight United Kingdom [25] 3 –5 Manios et al. (2009) 2287 55.4% of parents of overweight children and 88.0% of at-risk-of-overweight children perceived him/her as normal weight Greece [42] 2 –5 Maynard et al. (2003) 5500 32.1% of mothers of overweight children reported that he/she was about the right weight United States [43] 2 –11 Vuorela et al. (2010) 310 72.7% of parents of overweight boys and 93.8% of overweight girls classified them as normal weight Finland [44] 5 Wald et al. (2007) 612 82.5% of the parent of 3–5 years-old children their overweight children did not identify their child as overweight United States [45] 3 –12 hour sessions, including 32 sessions on healthy eating and seven sessions to encourage reduction of TV viewing for both parents and children. The stratified randomized clinical trial showed that the children reduced their television viewing time but actual times were not measured; parental estimates of the child's sedentary activity in previous week were lower than before the intervention . "
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    ABSTRACT: Background Childhood obesity is a public health epidemic. In Canada 21.5% of children aged 2–5 are overweight, with psychological and physical consequences for the child and economic consequences for society. Parents often do not view their children as overweight. One way to prevent overweight is to adopt a healthy lifestyle (HL). Nurses with direct access to young families could assess overweight and support parents in adopting HL. But what is the best way to support them if they do not view their child as overweight? A better understanding of parents’ representation of children’s overweight might guide the development of solutions tailored to their needs. Methods/design This study uses an action research design, a participatory approach mobilizing all stakeholders around a problem to be solved. The general objective is to identify, with nurses working with families, ways to promote HL among parents of preschoolers. Specific objectives are to: 1) describe the prevalence of overweight in preschoolers at vaccination time; 2) describe the representation of overweight and HL, as reported by preschoolers’ parents; 3) explore the views of nurses working with young families regarding possible solutions that could become a clinical tool to promote HL; and 4) try to identify a direction concerning the proposed strategies that could be used by nurses working with this population. First, an epidemiological study will be conducted in vaccination clinics: 288 4–5-year-olds will be weighed and measured. Next, semi-structured interviews will be conducted with 20 parents to describe their representation of HL and their child’s weight. Based on the results from these two steps, by means of a focus group nurses will identify possible strategies to the problem. Finally, focus groups of parents, then nurses and finally experts will give their opinions of these strategies in order to find a direction for these strategies. Descriptive and correlational statistical analyses will be done on the quantitative survey data using SPSS. Qualitative data will be analyzed using Huberman and Miles’ (2003) approach. NVivo will be used for the analysis and data management. Discussion The anticipated benefits of this rigorous approach will be to identify and develop potential intervention strategies in partnership with preschoolers’ parents and produce a clinical tool reflecting the views of parents and nurses working with preschoolers’ parents.
    BMC Nursing 08/2012; 11(1):12. DOI:10.1186/1472-6955-11-12
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