Parental perceptions of weight status in children: the Gateshead Millennium Study

Abstract

ObjectivesTo investigate parents’ perceptions of weight status in children and to explore parental understanding of and attitudes to childhood overweight.DesignQuestionnaires and focus groups within a longitudinal study.Subjects536 parents of Gateshead Millennium Study children, of which 27 attended 6 focus groups.Main outcome measuresParents’ perception of their child’s weight status according to actual weight status as defined by International Obesity Taskforce (IOTF) cut-offs. Focus group outcomes included parental awareness of childhood overweight nationally and parental approaches to identifying overweight children.ResultsThe sensitivity of parents recognising if their child was overweight was 0.31. Prevalence of child overweight was underestimated: 7.3% of children were perceived as ‘overweight’ or ‘very overweight’ by their parents, 23.7% were identified as overweight or obese using IOTF criteria. 69.3% of parents of overweight or obese children identified their child as being of ‘normal’ weight. During focus groups parents demonstrated an awareness of childhood overweight being a problem nationally but their understanding of how it is defined was limited. Parents used alternative approaches to objective measures when identifying overweight in children such as visual assessments and comparisons with other children. Such approaches relied heavily on extreme and exceptional cases as a reference point. The apparent lack of relevance of childhood overweight to their child’s school or own community along with scepticism towards both media messages and clinical measures commonly emerged as grounds for failing to engage with the issue at a personal level.ConclusionParents’ ability to identify when their child was overweight according to standard criteria was limited. Parents did not understand, use or trust clinical measures and used alternative approaches primarily reliant on extreme cases. Such approaches underpinned their reasoning for remaining detached from the issue. This study highlights the need to identify methods of improving parental recognition of and engagement with the problem of childhood overweight.

Exploring the basis for parents’ negative reactions to being informed that their child is overweight

“…physical activity and healthy eating) rather than weight itself has been forwarded as one means of minimising stigma (15) , this is not without challenges; in the present study most parents considered that their child had a healthy diet and was already sufficiently active for health. While previous research suggests that parents' perceptions in this respect are often inaccurate (6,7) , they would be unlikely to be motivated towards change unless these perceptions changed too. One approach to tackling this may be for schools to engage parents and children in monitoring their diet and physical activity levels against recommended standards, in order to provide parents with more objective information with which to make more informed judgements.…”

“…An important initial step in the process of preventing and tackling childhood obesity is raising awareness among parents that their child is overweight (2,3) , as without parental involvement and support, the potential impact of interventions to reduce obesity is limited (4,5) . Past work suggests that fewer than half of parents of overweight children correctly recognise their child as such (6) , with some studies estimating this to be as low as 30 % (7) . An example of how parental awareness can be raised is provided by the UK National Child Measurement Programme (NCMP), a nationwide school-based monitoring programme introduced in the UK in 2006 (8) .…”

Visual identification of obesity by healthcare professionals: an experimental study of trainee and qualified GPs

“…6 A physician has to raise the topic of weight in the first place to record a weight and this conversation is initiated presumably mostly on visual perception. A substantial proportion of parents of obese children underestimate their child's weight status, 7,8 and healthcare professionals may be no more accurate than the general population at estimating children's and adults' weight status.…”

Extracts of Seven Indian Plants Inhibit Human Topoisomerase I and Partially Inhibit Human Topoisomerase II

“…If a child is found to be overweight or obese, many school nurses notify the parent by sending a letter home with the child describing their placement on a BMI growth chart [35]. Since many parents do not favour 'official' methods of identifying overweight (i.e., BMI and/or percentiles), showed limited understanding of how overweight is defined for children, limited comprehension of the measures, and felt that they were irrelevant for their child [36,37], the letters from school nurses identifying weight status may not be effective. An evaluation of school based BMI and body composition screenings in California showed that only 12% of the letter formats contained an explanation of the measures used to determine the child's weight status [38] further limiting the parent's comprehension of the weight status conclusions.…”