As a parent, I consider my perceptions of my children’s development and health an
important component to maintaining their future health status. But how do I know these
perceptions are accurate? Or perhaps more importantly, helpful? In this month’s
Pediatrics, Wake et. al. (10.1542/peds.2017-3985) share their study investigating the bi-directional interactions between parent-perceived
overweight and body mass index (BMI). It seems intuitive that an aware and informed
parent could more readily assist a child with weight management. However, recent
evidence has challenged this notion (Robinson 2016), instead showing that parental
identification of their children as overweight did not protect against future weight
gain. But what comes first? Is it that the parent becomes more aware of their child’s
weight in response to an already increasing BMI or that the awareness itself instead
influences the child’s weight? Wake et. al. set out to investigate these important
questions utilizing the Long Study of Australian Children (LSAC).
The LSAC database follows two nationally-representative cohorts of over 9,000 children
dating back to 2004. During routine home visits, parents were longitudinally surveyed
on their perception of their child’s weight. All responses were dichotomized into
perceiving or not perceiving their child as overweight. The association between this
perception and a child’s BMI z-score was determined using lagged regression analyses.
As the authors hypothesized, there was a stronger association of a child’s increasing
BMI z-score preceding a parent’s perception of their child as overweight compared
to a parent’s perception occuring prior to a higher BMI z-score. These results challenge
prior studies suggesting that parents perceiving their child as overweight result
in worsening weight gain. Rather, Wake et. al. conclude that parents appropriately
perceive their children as overweight with rising BMI z-scores. Unfortunately, at
no point did a parent perceiving their child as overweight precede a falling BMI z-score.
What do we take from all of this? The data presented in this study suggest that there
is no need to discourage parents from acknowledging their child as overweight while
also recognizing that the appropriate perception doesn’t necessarily result in improved
BMI. Thus, as weight management approaches are developed, parent perception could
be included without being necessarily harmful but at the same time may not be helpful.
Check out the details of these results and other conclusions from the authors in
this month’s Pediatrics.
Robinson E, Sutin AR. Parental perception of weight status and weight gain across
childhood. Pediatrics. 2016;137(5)e20153957-e20153957. Doi:10.1542/peds.2015-3957