Is this child overweight? Parents don’t see what you do!

Michael G Burke, MD

Most parents of young children who are overweight or obese think their child’s weight is “just right,” according to a study conducted in Sweden. However, as their child grows older, more parents recognize when their child is too heavy-especially if he or she has reached the level of obesity.

These were the findings of an analysis of anthropometric measurements and parental questionnaires administered at regular child health visits for a large group of children when they were aged from 1 to 60 months. The analysis, which focused on data collected at the 2-year-old and 5-year-old visits, showed that at the 2-year-old visit, 14.9% of 2133 participants were considered to be overweight or obese as were 11.8% of 1862 participants at age 5 years, but only 3.6% of the parents of the heavy 2-year-olds thought their children weighed too much. Significantly more parents correctly identified that their child was overweight when he or she reached the age of 5 years, however, with 12.9% of parents of such children (most of whom were obese) indicating that their child weighed too much.

Compared with parents of normal-weight children, parents of overweight 2-year-olds were significantly heavier themselves and had less education (Berggren S, et al. Acta Paediatr. 2018;107[6]:1060-1064).

Thoughts from Dr. Burke

Blinded by love. I find it both endearing and concerning that parents of these Swedish children couldn’t see their child’s overweight or obesity, and it is not just the Swedes. In a 2010 US study, investigators asked parents to choose drawings of children with body types similar to their own child’s. More than 70% of parents with overweight or obese children chose drawings of children with a healthy weight (Clin Pediatr (Phila). 2010;49[8];790-798). The point is that parents may not see what you see, so we need to clearly explain to parents when their child is overweight or obese. We can’t assume that parents realize that their child has a worrisome medical condition, even when it is clear to us.