Parents’ underestimation of their child’s weight status. Moderating factors and change over time: A cross-sectional study

Abstract

BackgroundParents' underestimation of their child's weight status can hinder active participation in overweight prevention programs. We examined the level of agreement between the parents' perception of their child's weight status and the child's actual weight status, moderating factors, and change over time. MethodsThis cross-sectional study used data collected in 2009 (n = 8105), 2013 (n = 8844) and 2017 (n = 11,022) from a community-based survey conducted among parents of children age 2-12 years in the Netherlands. Parents classified their perception of their child's weight status on a 5-point Likert scale. In 2009 and 2013, the child's BMI was calculated from selfreported data by parents. The level of agreement between the parent's perception of the weight status and the actual weight status was examined using Cohen's kappa. The role of demographic factors on parents' perception were examined using logistic regression.

Actual Weight, Perceived Weight and Desired Weight of Romanian School Children by Parents and Children

“…Moreover, among normal weight children the discussions with parents were reported more frequently by children with incorrect underestimation of their weight, while among overweight children the discussion with parents on this issue were more frequent among those who correctly estimated that their weight was too high. Similarly to studies from other countries, these data suggest that if parents fail to correctly estimate the weight of their children, it is unlikely they will recognize the importance of interventions targeting the promotion of healthy nutrition and body weight management [ 5 , 32 , 33 , 34 , 35 ].…”

“…At the same time, our study showed that 21.1% of the parents did not correctly estimate the weight of their children; again, this situation was more frequent among the parents of overweight children in comparison with those with normal weight. Studies from other studies highlighted that parents’ misperceptions regarding the weight of their children vary depending on country/region, their children’s age group, the actual weight of children and the time when the study was performed, with several studies showing that these misperceptions are more likely among the parents of overweight children [ 28 , 29 , 30 , 31 , 32 , 33 , 34 ]. For instance, a large study from Australia showed that one quarter of mothers misclassified the weight of their 14 years old children, while a—country European study showed that 27.6% of parents of overweight/obese children underestimated their children’s weight status [ 5 , 7 ].…”

“…Parents’ underestimation of their child’s weight is due to the fact that some of them do not have a clear definition of what overweight means—they might have limited information from health professionals or even tend not to believe in physician/clinical charting of weight and BMI percentiles and estimate the weight through visual comparison with other children Another reason for weight status misclassification could be that the parents are aware of their child’s weight, but due to social undesirability, they do not wish to label their children as overweight [ 5 , 34 ]. There are some parents who recognize their child’s weight, but others may feel embarrassed to discuss their child’s overweight or obesity and may feel reluctant in seeking the advice of a health care professional [ 5 , 34 ]. In our study, both among normal weight and overweight children, those who correctly estimated their weight also more frequently had parents who did so in comparison with those who underestimated their weight.…”

Effects of Three Different Family-Based Interventions in Overweight and Obese Children: The “4 Your Family” Randomized Controlled Trial

“…Another potential limitation is the fact that this study enrolled participants based on parental evaluation of their child’s weight status, with most parents being of medium or higher educational level. It has been reported that parents of low educational level tend to underestimate their child’s weight and perceive them as normal weight although they are overweight or obese [ 44 ]. Therefore, results should carefully be generalized to medium to high educational level families.…”

Concordância entre dados antropométricos reportados vs. medidos e relação com as práticas parentais alimentares em idade pré-escolar

“…Alguns estudos indicam que os pais dificilmente identificam corretamente o peso dos filhos (e.g., Chaparro, Langellier, Kim, & Whaley, 2011;Duncan, Hansen, Wang, Yan, & Zhang, 2015;Eckstein et al, 2006;Jones et al, 2011;Oude Luttikhuis, Stolk, & Sauer, 2010;Ruiter et al, 2020;Tompkins, Seablom, & Brock, 2015). Uma meta-análise recente, com crianças e adolescentes entre os 2 e os 18 anos, demonstrou que 1 em cada 7 pais subestimou o peso dos filhos com peso normal e cerca de 50% subestimou o peso dos filhos com excesso de peso e obesidade, sendo esta subestimação maior em crianças entre os 2 e os 5 anos (Lundahl, Kidwell, & Nelson, 2014).…”