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

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.