Parental Recognition of Overweight in School‐age Children

West, Delia Smith; Raczynski, James M.; Phillips, Maggie; Bursac, Zoran; Gauss, C. Heath; Montgomery, Brooke E. E.

doi:10.1038/oby.2007.108

Cited by 106 publications

(134 citation statements)

References 37 publications

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“…Rather the parent perceived their child to be "just about right". Similar results with large sample sizes have been reported in the UK [7] and USA [8,9]. The conclusion from these studies is that parents with overweight children do not identify them as being overweight.…”

Section: Introductionsupporting

confidence: 76%

Parental Awareness and Perception of Their Children’s Body Size

Allen¹,

Prkachin²

2013

OJMP

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Objective: To investigate parents' misperception of their active children's size. Subjects: One hundred and forty male or female parents and their children from a youth soccer league participated. Actual Child Body Mass Index (BMI) percentiles and BMI categories were compared to the results of a Body Size Estimation Task and lifestyles questionnaire results. Results: Parents underestimated the body size of their children and placed them in a lower BMI category than the children actually belonged in. As was the case in other studies children in the unhealthy or at risk to become overweight category where seen as a healthy weight. Unlike other studies, many healthy weight children were seen as underweight. Conclusions: An explanation of body size misperception and underestimation of body size may be "change blindness". The growing prevalence of obesity in children may be better addressed by focusing on the parents' apparent lack of concern about excess childhood weight and the parents' identification of excess childhood weight as "just normal" rather than seeing excess weight as a potential problem.

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Section: Introductionsupporting

confidence: 76%

Parental Awareness and Perception of Their Children’s Body Size

Allen¹,

Prkachin²

2013

OJMP

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“…Emerging evidence suggests that simply raising awareness may have beneficial effects: when parents are given a simple report outlining their child' s BMI, classification (ie, underweight, normal weight, overweight, or obese), and general guidelines regarding diet and physical activity, they become more accurate in assessing their child' s weight status. 113 When parental perceptions regarding child weight are corrected, they are more likely to move from the precontemplation stage of change to the preparation or action stage of change. 114 Thus, awareness-raising strategies may facilitate stage change which could further facilitate desired actions (eg, diet change, increased physical activity).…”

Section: Clinical and Research Implicationsmentioning

confidence: 99%

Parental Underestimates of Child Weight: A Meta-analysis

2014

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BACKGROUND AND OBJECTIVE: Parental perceptions of their children' s weight play an important role in obesity prevention and treatment. The objective of this study was to determine the proportion of parents worldwide who underestimate their children' s weight and moderators of such misperceptions. METHODS:Original studies published to January 2013 were chosen through literature searches in PUBMED, PSYCHINFO, and CINAHL databases. References of retrieved articles were also searched for relevant studies. Studies were published in English and assessed parental perceptions of children' s weight and then compared perceptions to recognized standards for defining overweight based on anthropometric measures. Data were extracted on study-level constructs, child-and parent-characteristics, procedural characteristics, and parental underestimates separately for normal-weight and overweight/obese samples. Pooled effect sizes were calculated using random-effects models and adjusted for publication bias. Moderators were explored using mixed-effect models.RESULTS: A total of 69 articles (representing 78 samples; n = 15 791) were included in the overweight/obese meta-analysis. Adjusted effect sizes revealed that 50.7% (95% confidence interval 31.1%-70.2%) of parents underestimate their overweight/obese children' s weight. Significant moderators of this effect included child' s age and BMI. A total of 52 articles (representing 59 samples; n = 64 895) were included in the normal-weight meta-analysis. Pooled effect sizes indicated that 14.3% (95% confidence interval 11.7%-17.4%) of parents underestimate their children' s normal-weight status. Significant moderators of this effect included child gender, parent weight, and the method (visual versus nonvisual) in which perception was assessed. CONCLUSIONS:Half of parents underestimated their children' s overweight/obese status and a significant minority underestimated children' s normal weight. Pediatricians are well positioned to make efforts to remedy parental underestimates and promote adoption of healthy habits. Ms Lundahl conceptualized the study, coded the original studies, conducted the meta-analyses, and drafted the initial manuscript; Ms Kidwell coded a portion of the original studies, reviewed and revised the manuscript, and approved the final manuscript as submitted; and Dr Nelson contributed to the conceptualization of the study, critically reviewed and revised the manuscript, and approved the final manuscript as submitted.www.pediatrics.org/cgi

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“…Secondly, although parental underestimation of child weight status appears to be particularly pronounced for younger children (e.g. 2–5 years old) 33, 38, 39, high rates of parental underestimation (e.g. more than one third of parents underestimating) are still observed across older childhood and adolescence 30, 32, 38.…”

Section: Parental Underestimation Of Child Overweight and Obesitymentioning

confidence: 99%

Overweight but unseen: a review of the underestimation of weight status and a visual normalization theory

2017

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SummaryAlthough overweight and obesity are widespread across most of the developed world, a considerable body of research has now accumulated, which suggests that adiposity often goes undetected. A substantial proportion of individuals with overweight or obesity do not identify they are overweight, and large numbers of parents of children with overweight or obesity fail to identify their child as being overweight. Lay people and medical practitioners are also now poor at identifying overweight and obesity in others. A visual normalization theory of the under‐detection of overweight and obesity is proposed. This theory is based on the notion that weight status is judged relative to visual body size norms. Because larger body sizes are now common, this has caused a recalibration to the range of body sizes that are perceived as being ‘normal’ and increased the visual threshold for what constitutes ‘overweight’. Evidence is reviewed that indicates this process has played a significant role in the under‐detection of overweight and obesity. The public health relevance of the under‐detection of overweight and obesity is also discussed.

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Parental Recognition of Overweight in School‐age Children

Cited by 106 publications

References 37 publications

Parental Awareness and Perception of Their Children’s Body Size

Parental Awareness and Perception of Their Children’s Body Size

Parental Underestimates of Child Weight: A Meta-analysis

Overweight but unseen: a review of the underestimation of weight status and a visual normalization theory

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