Background

Having overweight/obesity (OW/OB) as a child is a strong predictor of adult obesity; however, parents may not be aware or recognize that their child has OW/OB. Accurate perception of weight status is essential in obesity prevention and treatment. Limited research has studied parent perception of child weight status in low-income Hispanic populations. This study examined the relationship between parent perception of child BMI category and actual child BMI category, and investigated differences between Hispanic and non-Hispanic parents.

Methods

Data were collected from 1950 3rd-5th graders from TX Sprouts, a cluster-randomized nutrition, gardening, and cooking intervention at 16 primarily low-income, Hispanic elementary schools around Austin, TX. Parent and child measures collected at baseline included: child age, sex, height, weight, BMI percentile, free/reduced lunch participation, and parent race/ethnicity and perception of child BMI category via self-administered questionnaire (I think my child is a-underweight, b-normal, c-overweight, d-obese). Chi-square tests assessed differences in percentages between actual and perceived BMI categories. Cohen’s Kappa assessed the concordance between parent perception of child BMI category and actual child BMI category.

Results

Students were 66% Hispanic, 53% female, and 69% low-income, with a mean age of 9.2 years. Overall, 49% of parents underestimated their child’s BMI category (κ = 0.13, p<0.001). Underestimation was higher among Hispanic parents, with 53% underestimating their child’s BMI category, compared to 43% of non-Hispanic parents (κ = 0.14, p<0.001). Only 1% of parents perceived their children to have obesity, despite 28% of children actually having obesity.

Conclusions

These findings suggest that many parents are unable to perceive OW/OB in their children, creating a barrier to potential treatment. Results highlight the need to educate parents on appropriate prevention and treatment options to avoid further complications of OW/OB.