Medical Author: Melissa Conrad Stoppler, MD
Medical Editor: Dennis Lee, MD

Parents may not always use the word "overweight" to describe their child, even though they select sketches of heavier children when asked to choose a picture resembling their child.

In a study published in the March 2006 issue of the journal Pediatrics, researchers asked parents of children 2 to 17 years of age to answer a survey about their child's health and appearance. In the survey, the parents were also asked to select a sketch from one of seven possible choices that most closely resembled their own child. Doctors measured the height and weight of the children and grouped them according to their body mass index (BMI). Those having a BMI between the 85th to 94th percentiles were classified as being at risk for overweight, while those with a BMI at the 95th percentile or greater were classified as being overweight. Of the 223 children studied, 20% were classified as overweight and 19% fell into the at-risk group.

Of the children in the overweight and at-risk groups, only 36% of the parents described their child as "overweight" or "a little overweight." Interestingly, 70% of these parents selected a middle- or heavier-weight image when choosing a sketch to represent their child's appearance. Those parents of older children in the study (older than six years of age) were more likely to describe their child as overweight, using words ("overweight" or "a little overweight") than were parents of younger children.

Since children learn about the importance of healthy food choices and physical activity from their parents at an early age, it is disturbing to note that many parents may not be able to identify children at risk for childhood obesity and related medical problems or may be in denial about the risks their children are facing. Encouraging parents to implement measures to combat childhood overweight and obesity will be difficult if the parents themselves do not perceive a problem with a child's weight.

If you have questions about your child's weight or size, ask your pediatrician if your child's BMI is within the normal range for his/her age. Your doctor can also help you develop strategies for weight management for the whole family.

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References: Eckstein, K.C., Mikhail, L.M., Ariza, A.J., Thomson, J.S., Millard, S.C., Binns, H.J.; Pediatric Practice Research Group. Parents' perceptions of their child's weight and health. Pediatrics. 2006 Mar;117(3):681-90.

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