Parag Bhatnagar

Yale researchers have found that parents are likely to underestimate their children’s weight status, even though parents can often give accurate estimates of their own weight status.

The researchers surveyed 1,007 parents of children between five and 15 years of age, asking the parents to provide feedback on their own eating patterns and weight status — classification as underweight, normal weight, overweight or obese  -— as well as on the eating patterns and weight of their children. Parents were much more likely to be accurate about their own obesity status rather than the obesity status of their children, with 45.2 percent of parents underestimating their children’s weight status and only 30.1 percent of parents underestimating their own weight status. The findings  point to clinical interventions and prevention methods to help treat children with obesity, according to the paper.

“Parents are key stakeholders in their children’s health, and whether they recognize obesity, and recognize it as a problem, is an important first-step to deciding to get pediatric obesity treatment,” said Janet Lydecker, a postdoctoral associate in psychiatry at the School of Medicine and paper co-author. “Although other work has shown that parents think their children are lighter than they actually are, I wanted to know what some of the associated characteristics of this misperception were.”

According to Lydecker, a little less than half of parents correctly identified themselves as having obesity. However, parents were overwhelmingly unable or unwilling to label their children’s weight category as “obesity” when the child’s height and weight fell into that range, Lydecker said. Only about 10 percent of parents correctly identified children with obesity as having obesity, she added.

The 45.2 percent of parents who misclassified their child’s weight range were not inaccurate in the same ways, Lydecker noted.

“Inaccuracy spanned the whole range,” she said. “Some thought their child was in the overweight range, others thought their child was in the healthy-weight range, and still others thought their child was in the underweight range.”

According to Lydecker, the researchers found that perceived child weight was more related to parents’ attitudes and feeding practices, including monitoring or restricting what their child could eat or urging them to clean their plates, than it was to the actual weight of the parent or of the child.

According to the Centers for Disease Control and Prevention, children with obesity face a variety of health problems. They are more likely to experience high cholesterol, high blood pressure, bone and joint problems, prediabetes and sleep apnea. Children and adolescents with obesity may also face social stigmatization and poor self-esteem, according to the CDC. Having obesity during childhood also puts children at an increased risk of having obesity as adults. According to the Mayo Clinic, one of the best strategies to help children with obesity is to “improve the diet and exercise habits of [the] entire family.”

“Obesity has become recognized as a public health issue both in the United States and in other countries, and many health organizations including the World Health Organization, are working to implement data-driven prevention measures. “Increased political commitment is needed to tackle the global challenge of childhood overweight and obesity,” said Sir Peter Gluckman, a co-chair of the Commission on Ending Childhood Obesity, in a January press release.

In a January statement in response to the final report from the World Health Organization’s Commission on Ending Childhood Obesity, Connecticut Rep. Rosa DeLauro said that the “childhood obesity epidemic has reached new levels in the U.S. and around the world, and there are reasonable reforms that we can enact to change our course.” She stressed the importance of giving “parents the tools they need to make healthy choices.”

Lydecker suggested that pediatricians and school nurses could tell parents what their child’s weight and body mass index meant in terms of weight status. She noted that there are also online calculators, such as one on the CDC website, which could help parents determine their child’s weight status.

“Making healthy lifestyle changes can be some of the hardest changes to make,” she said. “The number one thing that family members and those outside of the family can do is support parents and their children” as they make these lifestyle modifications.

Lydecker said that the researchers have planned several other projects to “better understand parents and the great efforts they are making to improve the health of their families.” One such project will examine families with parent-child weight mismatch — instances where parents at a healthy weight have children with obesity — to investigate if stress or feeding practices could play a role in the observed weight mismatch.

According to the CDC, obesity has more than doubled in children and quadrupled in adolescents in the past 30 years, and nearly 18 percent of children ages six to 11 had obesity in 2012.