Appropriate levels of parental perception and concern about child weight are important components of successful obesity treatment, but the factors that contribute to these attitudes need clarification. The aim of this study was to identify child and parent characteristics that best predict parental perceptions and concerns about child weight. A cross-sectional design was used to assess characteristics of parents (e.g. age, income, and feeding attitudes) and children (e.g. body composition, ad libitum intake, and reported physical activity). Results are reported for 75, 4–6 year-olds from diverse ethnicities. Perceived child weight and concern were measured with the Child Feeding Questionnaire (CFQ). Multiple linear regression was used to identify the best models for perceived child weight and concern. For perceived child weight, the best model included parent age, children’s laboratory intake of sugar-sweetened beverages (SSB) and palatable buffet items, and two measures of child body composition (ratio of trunk fat-to-total fat and ratio of leg fat-to-total fat). For concern, child android/gynoid fat ratio explained the largest amount of variance, followed by restrictive feeding and SSB intake. Parental perceptions and concerns about child weight are best explained by models that account for children’s eating behavior and body fat distribution.
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