Parents underestimate their child's overweight

Aim: The aim of this study was to evaluate parents' ability to perceive the weight status of their children. Methods: This cross-sectional study was performed on 5 (n = 310) and 11-year-old (n = 296) children. The height, weight and waist circumference were measured. Body mass index (BMI, kg/m superset of) was calculated. The International Obesity Task Force criteria and the British cut-off points were used to classify BMI and waist circumference. Parents filled out a questionnaire concerning their perception of the weight class of their child. The parents and the 11-year-old children estimated their own weight class. For analysis, the measured and perceived weight classes were divided into two categories; normal weight (including underweight) and overweight or obese. To measure the agreement cross-tabulation with Cohen's Kappa was used. Explanatory variables associated with misclassification of overweight children as normal weight were examined by logistic regression modelling. Results: The prevalence of overweight (including obese) was 17.4% and 21.6% in 5- and 11-year-old children in this study. Only a few parents misclassified their normal weight children as overweight. By contrast, a majority of parents to the 5-year-old children and about half of the parents to the 11-year-old children misclassified them as normal weight. Using waist circumference for body size classification did not improve parents' performance. Mothers performed best when estimating own weight class. Conclusion: A majority of parents fail to recognize overweight or obesity in their 5- and 11-year-old children. The underestimation of overweight may impair the motivation of the parents to adopt weight control.