Clueless parents? Not necessarily…

A full 43% of parents of an underweight child consider their child to be of average weight and 1.5% thought their underweight child was even overweight. Twice as many parents say they are concerned that their child might be overweight compared to underweight. Sixty percent of underweight girls don’t think they are underweight, compared to half of boys. Parents of girls are more like to incorrectly see their child as overweight than parents of boys. Almost half (49%) of parents of children who fall in the overweight category on BMI growth curves fail to identify their child as being overweight.

These are the findings in a press release issued by the University of Melbourne School of Behavioral Science. Doctoral researcher Pene Schmidt had examined data from a survey of more than 2,100 Victorian children ages 4-12 and their parents. "This study also suggests a strong social bias among both parents and children towards thinness," she said. "We have to make sure that with the current climate and the focus on obesity we don't end up seeing unintended effects occurring at other end of weight spectrum, with more children being underweight." This paper is unpublished, so no further information on the survey or methodology of this analysis is publicly available, but the story has made its way around the globe in under a day.

Which point do you think media has headlined? Concern for the underweight children or the larger ones?

“Parents are in denial about their obese children,” said The Age. “Parents often blind to obesity,” said the Globe and Mail, reporting:

The battle against the childhood bulge has a new culprit: clueless parents. While public awareness campaigns have been carping on the issue of childhood obesity for years, an Australian study released this week has found that mom and dad are not getting the message: Almost half of all parents of overweight children thought their kids were a normal weight…

The results come as little surprise to Canadian researchers. "Parents have poor judgment when it comes to child weight issues," said Paul Veugelers, Canada Research Chair in Population Health at the University of Alberta. "They are usually very far off when you ask whether their children are obese." … Many parents overlook their child's unhealthy weight because they believe it is normal, research suggests…

The University of Melbourne researchers said parents would not act to help their children gain or lose weight if they did not see the problem… The Australian research shows just how hard it could be to challenge parents' perceptions of their children.

Tam Fry, from the National Obesity Forum, said that the results were "unsurprising". He said: "There was recent research in this country which showed that a similar proportion of health professionals were unable to make the distinction. "We live in a society where being big is becoming far more common, and is seen as normal." He said that it was hard for health visitors and doctors to intervene if they were likely to meet a hostile response from the parent.

This isn’t the first time that parents have been blamed for failing to recognize that their children are too fat, while underweight children are paid little notice in the news. For years, even in the medical literature, parents have been accused of being in denial, being “blind to the realities of childhood fat,” being “guilty of overlooking the obvious,” and failing to appreciate the problem and dangers childhood obesity. While it’s become popular to indict parents of ‘overweight’ children for being irresponsible, to the point of needing government intervention, it’s not the parents’ fault.

It’s that childhood obesity is so poorly understood. Most people think it looks like the extreme examples as seen on television. They’d never imagine what children who cross the line to enter the ‘overweight’ percentile on BMI growth curves look like. The epidemic of childhood obesity probably wouldn’t elicit near the upset if they did. The definitions of how children’s sizes are labeled are completely arbitrary and vary among cultures and through the years.

More than a year ago, we took a look at the illogicality of child obesity definitions, which might be helpful for those who may have missed it. Before any more parents are blamed for failing to see a conern or receive interventions to help them admit a problem, check out that adorable little girl used as an example of the alarming number of 20 million children under age five who are too fat.

When we hear scary statistics that, for instance, rates of childhood obesity among children aged 2-5 years has soared from 5% in 1971 to 13.9% in 2004, that doesn’t mean that children’s weights have ballooned by nearly 9% over the past 33 years. Nor does it mean that 13.9% of children today weigh hundreds of pounds as seen on TV. It means that 9% more children today have crossed that arbitrary threshold to receive the clinical label of being ‘overweight.’

To get a more realistic picture of what and ‘obese’ child looks like, we used the CDC’s latest BMI growth charts and calculator for the cutoffs for ‘overweight’ and ‘obesity’ in children.

A 6-year old girl who is 3 foot, 9 inches tall would be considered to be a “healthy, normal weight" at 49 1/4 pounds (BMI 17.1).

If she gained 1/4 pound more, however, she becomes ‘overweight’. Untold numbers of children classified as ‘overweight’ are within a fraction of a pound or few pounds of ‘normal.’

However, if this little girl grew a mere 1/8 inch, she would be considered to be a “healthy, normal weight” again!

At 54 1/2 pounds (BMI 18.9) she crosses the 95th percentile cut-off and is now labeled ‘obese.’ A very different picture of childhood obesity than the mainstream media is portraying.

However, if this little girl was a mere 1/8 inch taller, at 3-9 1/8 inches tall, she would be merely “overweight” again.

So, for a 6-year old girl who theoretically isn’t growing taller, around a mere 5 pounds makes the difference between being labeled as a “normal” weight or all the way to being “obese.”

It’s no wonder that most parents aren’t readily able to recognize that their child is overweight or obese. Increasing numbers of parents are also not readily buying into the belief of a need to medicalize their healthy, active children based on such a spurious label. Parents, it seems, have more common sense than a lot of experts and journalists.

© 2008 Sandy Szwarc