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  • 9 of 10 Parents of Overweight Children Don't See the Problem

    Nearly 95% of parents of overweight children in America don't perceive their child as overweight, according to a new study that underscores a phenomenon one editorial writer describes as "oblviobesity."

    The research, which appears in the June issue of Childhood Obesity (.pdf) analyzed data from National Health and Nutrition Examination Surveys (NHANES) administered between 1988 and 1994, and again between 2007 and 2012.

    Researchers compared an individual child's BMI with his or her parent's answer to the questions, "Do you consider [child's name] to be overweight, underweight, just about the right weight, or don't know?" (earlier survey) and "How do you consider [child's name] weight?—overweight, underweight, about the right weight, or don't know," (later survey). The comparison allowed authors of the study to gauge just how far parent perceptions veered from reality.

    They veered a lot. In the later survey 94.9% of parents of overweight children described their child's weight as "just about right," a slight decline from the 96.6% of parents who provided that response in the earlier survey.

    That perceived improvement, however, was offset by an increase in the number of parents who perceived their obese child's weight to be "just about right"—about 79% of parents of obese boys, and 68% of obese girls, numbers that increased from 69% and 59%, respectively. What that means, according to researchers, is that that probability of a parent appropriately perceiving his or her child as overweight or obese dropped by 30% between the surveys.

    Other findings:

    • Overall, the children sampled in the latest survey were "significantly heavier" than their counterparts in the earlier survey, with mean BMI increasing from .23 to .37.
    • The declining tendency to misperceive the weight of an obese or overweight child was most pronounced among black parents.
    • The apparent threshold for a parental perception of overweight shifted: in the earlier study, the majority of perceived overweight children were overweight; in the most recent study, the majority of children perceived as overweight were obese or severely obese.

    In an editorial that appeared in the same issue as the study, author David L. Katz, MD, described a number of earlier studies that produced similar results—both in terms of parental perceptions of a child's weight, and the perceptions of children themselves. He dubbed the phenomenon "oblivobesity."

    For their part, researchers point to several possible causes for the increasing misperceptions, including growing overall obesity rates that may prompt parents to look at peers for standards, poor communication between parents and the medical community, a belief that weight will be "outgrown," and an unwillingness "to label their child as overweight owing to societal pressures of maintaining a lower weight and/or the stigma often attached to obesity."

    Authors cite public health initiatives to decrease childhood obesity rates, but write that "the opportunity has not yet been fully realized and pediatricians' commitment may need revitalizing."

    In his editorial, Katz frames the problem in dire terms.

    "If parental inattention fosters a rising mean BMI among children globally, and a rising mean BMI fosters acclimation among parents to that ever-higher norm, then obesity in our children becomes the new normal," he writes.

    APTA offers extensive resources on the PT's role in prevention and wellness, as well as on behavior change in the patient and client.

    Research-related stories featured in PT in Motion News are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association's PTNow website.

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