Parental Perception of Weight Status and Weight Gain Across Childhood

Abstract

Background and Objectives Parents of children who are overweight often fail to accurately identify their child’s weight status. Although these misperceptions are presumed to be a major public health concern, little research has examined whether parental perceptions of child weight status are protective against weight gain during childhood. Our objective was to examine whether parental perceptions of child weight status are associated with weight gain across childhood. Methods Data from the Longitudinal Study of Australian Children were used to assess parental perceptions of child weight status and to examine changes in researcher measured child BMI-Z scores across childhood, from 4 to 13 years old. 3,557 Australian children and their parents participated. Results Children whose parents perceived their weight as being ‘overweight’, as opposed to ‘about the right weight’, gained more weight (increase in BMI-Z score) from baseline to follow up in all analyses. This finding did not depend on the actual weight of the child; the association between perceiving one’s child as being overweight and future weight gain was similar among children whose parents accurately and inaccurately believed their child was overweight. Conclusions Contrary to popular belief, parental identification of child overweight is not protective against further weight gain. Rather, it is associated with more weight gain across childhood. Further research is needed to understand how parental perceptions of child weight may counter-intuitively contribute to obesity.

Feeding and Mealtime Correlates of Maternal Concern About Children's Weight

“…12 For such interventions to be successful at reducing obesity, it’s essential that concern prompts parents to participate in evidence-based approaches to improve children’s energy balance, not actions that contribute to weight gain or other negative health problems. Evidence is mixed as to whether parental concern about children’s weight is associated with healthy changes in child weight 10, 14 or parents’ participation in behaviors that promote children’s healthy weight. 5, 8, 15–18 Some studies have found that parents concerned about their child’s weight are more likely to limit screen time, encourage physical activity, and change the family diet, as compared to parents who are not concerned.…”

Implementation of a School Nurse-led Intervention for Children With Severe Obesity in New York City Schools

“…Multiple reasons for lack of parent participation may exist; parents may have transportation barriers, lack the ability to take time off from their job, have limited family support, the child may resist, or the parents may simply be uninterested in the program (Brennan, Walkley, & Wilks, 2012; Moore & Bailey, 2013; Sonneville, La Pelle, Taveras, Gillman, & Prosser, 2009). It is also possible that parents do not see their child's weight as a concern (Lundahl, Kidwell, & Nelson, 2014; Robinson & Sutin, 2016; Trigwell, Watson, Murphy, Stratton, & Cable, 2014). Efforts to engage parents with sensitivity to these barriers are key.…”

Parental perception of child weight and inflammation: Perceived overweight is associated with higher child c-reactive protein

“…Although counterintuitive, accurate parent perception of overweight has previously been associated with the trajectory of the child’s weight gain: Children perceived as overweight by parents gained more weight over time than children perceived as normal weight (3). In previous research, this association was mediated, in part, by the child’s own weight perception and dieting-related behavior (4).…”

“…Recent evidence, however, suggests that parent perception of their child as overweight may be harmful rather than beneficial for the child’s weight gain trajectory. Parent perception of overweight at age 4, for example, is associated with greater child weight gain up to age 12 (3), even after controlling for baseline weight; a finding that has replicated (4, 5). A quasi-experimental study on BMI report cards came to a similar conclusion (6): adolescent girls who had a BMI just over the threshold of overweight were classified as “outside a healthy weight” and subsequently gained more weight than girls who had a BMI just under this threshold (a similar effect was not found for adolescent boys).…”