Perception of body weight status: a case control study of obese and lean children and adolescents and their parents

Abstract

Background: The objective of this study was to investigate differences in weight perception and self-concept of obese and lean children, and to examine parents' awareness of overweight in themselves and their children. A total of 59 obese patients aged 7-17 years and 49 of their parents from a pediatric obesity out-patient clinic participated and were compared with 96 normal-weight patients and 81 of their parents from a pediatric pulmonary disease out-patient clinic.

Methods: Children's and parents' self-perception of weight, desire for weight change and weight concerns, children's belief that their desired weight can be achieved, and parents' perception of their child's weight status were assessed using single questionnaire items. Children's self-concept was measured by the Self-Perception Profile for Children. In addition, children drew pictures about themselves and their favorite activity.

Results: Obese patients wished to change their weight more frequently (p < 0.001) and had more weight concerns (p < 0.001). Their self-concept was significantly more negative. Physical activities were more common in their drawings than in those of normal-weight peers. Parents of obese children were more frequently overweight or obese themselves (p < 0.001). 35 of them and 73 parents of normal-weight children perceived their own weight realistically. Of the parents with overweight or obese children, 69.4% perceived their own child as overweight and 28.6% as very overweight, whereas 83% of them were obese.

Conclusion: Children and adolescents as well as their parents recognize overweight as a health problem. In the majority, weight perception matches real body weight. Most parents at least recognize overweight in their children.

Fig. 1

Examples of children’s drawings of self-concept: self-portraits of 3 children depicting the child with his/her favorite activity: a 8-year-old girl, 37.2 kg, 1.35 m, 94th BMI percentile; b 7-year-old boy, 27.3 kg, 1.34 m, 30th BMI percentile; c 7-year-old boy, 24.4 kg, 1.26 m, 34th BMI percentile.

Fig. 2

Weight status of a parents with overweight/obese children: 30.6% normal-weight, 36.7% overweight, 32.7% obese; b parents with normal-weight children: 54.4% normal-weight, 37.0% overweight, 8.6% obese. Parents of obese children are more frequently overweight or obese themselves in relation to parents of normal-weight children (p < 0.001).