Parental concerns about childhood obesity: time for a reality check?

December 10, 2007 Volume 2 Issue 3
  • One-quarter of US children age 6-17 are either obese or overweight, based on parent report of children's height and weight.
  • Less than 10% of parents of obese children age 6-11 are "very concerned" about their children's weight.
  • More than 40% of parents of obese children age 6-11 perceive their children's weight status as "about the right weight".
  • Obese children age 6-17 are more than twice as likely to have asthma as children who have healthy weight.

Adults in the US rate obesity as one of the 3 most important health concerns for children (National Poll on Children’s Health, Vol 1, No. 2). It is critical to address obesity in the childhood years -- at home, and in schools and in other community settings. But in order to address childhood obesity, parents must recognize that children have excess weight for their height. Parents must also be concerned enough to want to do something about their children's obesity.

One of the greatest challenges for parents is that their child’s obesity may not be easy to judge subjectively. However, there are objective national standards set for children in the US based on measurements of thousands of boys and girls of different ages. These standards define obesity based on the body mass index (BMI). "Obesity" is defined having as a BMI at or higher than the 95 th percentile for children of the same age and gender. "Overweight" is defined as having a BMI at or higher than the 85 th percentile, but lower than the obese group.

BMI Levels - Parent Reported Children’s Ht & Wt

In August 2007, the C.S. Mott Children’s Hospital National Poll on Children’s Health asked parents to report their oldest children’s height and weight. From height and weight data, BMI was calculated and categorized as healthy, overweight, or obese based on age- and genderspecific ranges. Parents were also asked to rate their children’s weight status and concern with their children’s weight.

Results indicate that 15% of children age 6-11 and 10% of children age 12–17 are obese. Overall, 25% of children age 6-17 are either obese or overweight (Figure 1).

BMI levels for children age 6-17 did not differ by parent education, household income, or children’s insurance status.

Parent Perception and Concern

Over 40% of parents of obese children age 6-11 perceive their children’s weight status as “about the right weight” (Figure 2). Only 13% of parents with obese children age 6-11 rated their child as being “very overweight” compared with 31% of parents of obese children age 12-17.

Similarly, only 7% of parents of obese children age 6-11 are “very concerned” about their children’s weight, whereas 46% of parents of obese children age 12-17 are “very concerned”.

Parents’ concern with children’s weight also differed by race/ethnicity: 41% of blacks were “very concerned” with their obese children’s weight, whereas only 30% of whites and 17% of Hispanics were “very concerned”.

Regional Differences

A somewhat higher proportion of children in the South (17%) are obese compared to children in the West (10%), Midwest (10%) and Northeast (8%) (Figure 3).

Parents’ concern about their obese children was lower in the Midwest with only 13% of parents “very concerned”, compared with 29% in the South, 31% in the West and 37% in the Northeast. Nearly half of all parents in Midwest and West are either “not at all concerned” or “not too concerned” about their obese children’s weight (Figure 4).

Childhood Obesity and Health Conditions

Based on parental responses to the C.S. Mott Children’s National Poll on Children’s Health, obese children age 6-17 are more than twice as likely to have asthma (29%) than healthy weight children (12%). In addition, children were more likely to be obese (34%) when parents rated their child’s physical health status as good, fair, or poor compared with children who were rated in excellent or very good health (8%).

Although overall only 27% of all parents of obese children age 6-17 are “very concerned” about their children’s weight, 84% of these same parents believe it is “very important” for doctors to address obesity with adolescents during routine check-ups.

Implications

Based on parent-reported child height and weight in this C.S. Mott Children’s Hospital National Poll on Children’s Health, 25% of US children age 6-17 are either obese or overweight in 2007. This estimate is somewhat lower than prevalence (35%) estimated from recent national studies in which children’s height and weight are measured in person. This discrepancy suggests that parents may have under-estimated their children’s weight and/or over-estimated their children’s height in response to this poll.

It is very apparent from these results that there is a stark mismatch between children’s obesity status and parents’ perceptions of whether their children’s weight is appropriate for their height, especially among parents of obese children 6-11 years old. Parents who do not recognize obesity in their children, or who are not concerned even if they do recognize obesity, may be less inclined to help modify their children’s diet and physical activity patterns. Without parents’ help, school and community efforts to mitigate the childhood obesity epidemic may have limited success.

Health care providers can play an important role in helping parents to recognize obesity, and take steps to modify a child’s diet and activity levels. The National Poll on Children’s Health found that the vast majority of parents of obese children believe it is very important for doctors to address obesity with adolescent patients during routine check-ups. Parents’ willingness to discuss obesity at their children’s medical appointments indicates that many parents view doctors as a welcome source of information about strategies for working on obesity. This attitude may stem from parents’ recognition that obese children are at higher risk than healthy-weight peers for health problems such as asthma.

Data Source

This report presents findings from a nationally representative household survey conducted exclusively by Knowledge Networks, Inc, for C.S. Mott Children’s Hospital. The survey was administered from July 20-August 9, 2007, to a randomly selected, stratified group of adults aged 18 and older (n=2,060) with and without children from the Knowledge Networks standing panel that closely resembles the U.S. population. The sample was subsequently weighted to reflect U.S. population figures from the Census Bureau. About two-thirds of the sample were parents. The response rate was 71% among Knowledge Networks panel members contacted to participate.

C.S. Mott Children’s Hospital National Poll on Children’s Health
Director: Matthew M. Davis, MD, MAPP
Associate Director: Sarah J. Clark, MPH
Manager & Editor: Dianne C. Singer, MPH
Data Analyst: Acham Gebremariam, MS

This Report includes research findings from the C.S. Mott Children's Hospital National Poll on Children's Health, which do not represent the opinions of the investigators or the opinions of the University of Michigan. The University of Michigan reserves all rights over this material.

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Percentage of children age 6-17 who are overweight or obese
Parental perception of children's weight status for children who are obese
Percentage of children age 6-17 who are obese