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I Think, Therefore My Child Is (Or Is Not) Overweight? :

November 9, 2018

As a parent, I consider my perceptions of my children’s development and health an important component to maintaining their future health status. But how do I know these perceptions are accurate?

As a parent, I consider my perceptions of my children’s development and health an important component to maintaining their future health status. But how do I know these perceptions are accurate?  Or perhaps more importantly, helpful?  In this month’s Pediatrics, Wake et. al. (10.1542/peds.2017-3985) share their study investigating the bi-directional interactions between parent-perceived overweight and body mass index (BMI).  It seems intuitive that an aware and informed parent could more readily assist a child with weight management.  However, recent evidence has challenged this notion (Robinson 2016), instead showing that parental identification of their children as overweight did not protect against future weight gain.  But what comes first?  Is it that the parent becomes more aware of their child’s weight in response to an already increasing BMI or that the awareness itself instead influences the child’s weight?  Wake et. al. set out to investigate these important questions utilizing the Long Study of Australian Children (LSAC).

The LSAC database follows two nationally-representative cohorts of over 9,000 children dating back to 2004.  During routine home visits, parents were longitudinally surveyed on their perception of their child’s weight.  All responses were dichotomized into perceiving or not perceiving their child as overweight.  The association between this perception and a child’s BMI z-score was determined using lagged regression analyses.  As the authors hypothesized, there was a stronger association of a child’s increasing BMI z-score preceding a parent’s perception of their child as overweight compared to a parent’s perception occuring prior to a higher BMI z-score.  These results challenge prior studies suggesting that parents perceiving their child as overweight result in worsening weight gain.  Rather, Wake et. al. conclude that parents appropriately perceive their children as overweight with rising BMI z-scores.  Unfortunately, at no point did a parent perceiving their child as overweight precede a falling BMI z-score. What do we take from all of this?  The data presented in this study suggest that there is no need to discourage parents from acknowledging their child as overweight while also recognizing that the appropriate perception doesn’t necessarily result in improved BMI.  Thus, as weight management approaches are developed, parent perception could be included without being necessarily harmful but at the same time may not be helpful.  Check out the details of these results and other conclusions from the authors in this month’s Pediatrics.

 

Reference:

Robinson E, Sutin AR.  Parental perception of weight status and weight gain across childhood.  Pediatrics.  2016;137(5)e20153957-e20153957.  Doi:10.1542/peds.2015-3957

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