Parents of Overweight Children Do Not Perceive the Health Risks

The parents of children presenting to the pediatric emergency department (PED) may recognize that their children are overweight, but they do not perceive this to be a significant risk to their children’s well-being, according to the results of a new study presented on October 14, 2013, at the American College of Emergency Physicians annual meeting in Seattle.

“A parent’s perception of a child’s weight can contribute to obesity,” lead author Elaine Josephson, MD, Program Director, Emergency Medicine Residency, at Lincoln Medical & Mental Health Center, Bronx, NY, told ConsultantLive. “Children are dependent on their parents control for most daily needs in life. Therefore if a parent does not perceive their child to be obese, food choices for meals or snacks could be affected, maybe fast foods, as an example; or, specifically encouraging more exercise may not seem as important.”

Childhood obesity has become an important public health issue, especially in inner-city populations. Dr Josephson and colleagues sought to evaluate the perception of parents whose children were seen in a PED located in an urban teaching hospital. “By evaluating this underserved area population, we intended to highlight the significant need to better understand how to promote health awareness issues, with the goal of subsequently educating parents on interventions to help reduce childhood obesity,” she said.

In an observational prospective cohort study, the participants were the parents who accompanied  school-age children from 4- to 16-years-old visiting the PED. Forty-seven parents completed the survey; their children had a mean age of 9 years and mean BMI percentile of 71.6.

A comparison of the parents’ perception of the child’s weight vs BMI percentile did achieve statistical significance. However, the parents did not perceive their children’s weight as a health problem when compared with their BMI percentile.

“Despite being previously informed by a physician about their child’s weight as posing a health risk, the parents did not perceive this as an issue,” said Dr Josephson. “The reasons could be multifactorial or specific to that individual's circumstance.” She speculates that the parent's perception of their own body habitus, the socioeconomic status of the population, and the education level or cultural aspects could influence this finding.

Primary care physicians can play an important role in comunicating with and educating parents of overweight children about this health issue, she said. “We plan to further investigate this in our study. Perhaps primary care physicians can provide appropriate information on the health risks of childhood obesity geared toward the education level of the parents, including examples and individualized goals and follow-up that is easily obtainable,” said Dr Josephson.

“Primary care physicians also should assess the parent’s understanding of the information given to them. If the parents of these children do not perceive their obesity to be a major problem, and set a positive example, then it is difficult for the children to understand this and change their activity and eating habits. Primary care physicians cannot always assume that the information they give to the parents at one visit will be understood and their recommendations always followed.”

Source: Josephson E, Teitell R, Prota D, Waseem M, Kornberg R. Childhood obesity: assessing the parents’ perceptions of children’s weight as a health risk. Abstract No. 191. Presented October 14, 2013, at the American College of Emergency Physicians annual meeting; October 14-17, 2013; Seattle.