NEW ORLEANS — Roughly one-quarter of overweight children were not identified as such by their parents in a survey of 308 child-parent pairs from an inner-city clinic.
This finding was true independent of race or ethnicity and occurred most commonly if the child was under 9 years of age, Dr. Maria Fernanda Nota and colleagues at the University of Louisville (Ky.) reported at the Southern regional meeting of the American Federation for Medical Research.
“I'm not sure why, but maybe it's because they're 'babies,'” Dr. Nota said in an interview.
Although obesity is prevalent in American children of all ages, especially in minorities, little is known about the role played by racial and ethnic differences in parents' perception of their children's weight status.
The investigators surveyed African American, Hispanic, and white parents of 2− to 17-year-old children. There were 104 African American parent-child pairs, 104 Hispanic pairs, and 102 white pairs.
Using a bilingual questionnaire, parents reported their own weight status and their perception of their child's weight as “underweight,” “just right,” or “overweight.” They also noted whether they were concerned about their child's weight. Children 9 years of age or older also identified their own weight status.
Weight and height measurements were recorded for all children. Weight status was defined by body mass index (BMI) as “normal” if it was in the 25th to 75th percentile or “overweight” if it exceeded the 95th percentile. The 76th to 94th percentile was intentionally excluded to provide a clear demarcation between groups, Dr. Nota said.
Parents identified their child's correct weight status in 76% of parent-child pairs. In all weight categories, accuracy of parental perception of their child's weight did not vary as a function of race or ethnicity, gender, or age.
Concerning the obese category, parents were significantly less likely to recognize 2− to 8-year-old girls as obese, compared with older girls (50% vs. 97%).
Comparable percentages of parents recognized obesity in both young (73%) and older (82%) boys.
Hispanic parents reported being concerned about their child's weight more often than did whites or African Americans, but this trend did not reach statistical significance.
One or both parents were obese in 50% of Hispanic pairs, 57% of white pairs, and 71% of African American pairs. Three-fourths of both obese and nonobese parents recognized obesity in their children, the authors reported.
Obese 9− to 17-year-old children with one or both obese parents recognized their own obesity as often as did children of normal-weight parents.
Dr. Nota was surprised that parents did not recognize obesity as well in younger children. But session comoderator Dr. Bryan Burke suggested that not all parents want to know about their child's weight.
In his home state, the Arkansas School BMI Assessment Project—initiated in 2003 to track the state's obesity epidemic—has been decried by parents as being bad for their children's self-image because it mandates that schools measure body mass index annually for all children in public school grades K-12 and send that information home with children's report cards.
Although the Centers for Disease Control and Prevention estimates that 60% of adult Arkansans are either overweight or obese, parent groups are now working to overturn the law, said Dr. Burke, a pediatrician with the Arkansas Children's Hospital in Little Rock.