Maternal and child awareness and expectations of child overweight

Abstract

Objective: We investigated mothers' and children's assessments of body weight and their expectations about perceived body size in relation to overweight of the children.

Methods: We performed a case-control study of 111 cases of overweight children and 149 controls of non-overweight children (mean age 8.1 years) and their mothers. All were examined and interviewed about their assessment of body weight and their perception of a normal, attractive and acceptable body size.

Results: Case children were less able than control children to correctly assess their own body weight (p < 0.001), as were mothers of overweight children (MOC) to assess their children's body weight (p < 0.001). The majority of mothers from both groups wished their children to have a normal body size, but 18% of MOC wished their children to have an overweight body size (p < 0.013). The majority of case children, control children and mothers found a normal body size for boys and girls to be the most attractive and socially acceptable, but more MOC found overweight among boys to be the most attractive (p = 0.006).

Conclusion: Overweight children and their mothers show increased uncertainty in the assessment of overweight and obesity, but the perception of a normal, attractive and socially acceptable body size is not distorted.

Fig. 1

Distribution of included and withdrawn mother-child pairs (DNBC = Danish National Birth Cohort; *e.g., father was the legal guardian of the child, child did not wish to participate, national nurse’s strike and grandparents’ traffic accident).

Fig. 2

Body pictograms, adapted from Rand and Resnick [26]. Reproduced with permission from Stunkard, Rand and John Wiley and Sons Ltd. Classification of the ratings were as follows: size 1+2 = underweight, 3+4 = appropriate weight (in this paper referred to as normal weight), 5 = slightly overweight, 6+7 = moderately overweight, 8+9 = very overweight.