Childhood obesity has become one of the most impending public health crises facing the developed world. As adults have gotten larger, so too has the generation behind them, with rates of obesity among children ages 6 to 11 more than doubling from seven to 18 percent between 1980 and 2012, and from five to 21 percent among teens ages 12 to 19, as per the Centers for Disease Control and Prevention (CDC). These increased rates will forecast the rise of several medical conditions like type 2 diabetes, heart disease, and certain cancers as obese children become obese adults.

At the same time, though, a wellspring of research has emerged surrounding the uncertainty of current treatment guidelines aimed at curbing overweightness and obesity via weight loss treatment. To date, no research shows more than a modest and unsteady reduction of weight as a result of diet and exercise for most people, even when coordinated with medical professionals. Surgeries that resculpt the digestive system to lessen appetite or decrease the ability to absorb food show more promise, but are laden with physical drawbacks and are often recommended only for those with severe obesity — and even with these, there is still a high degree of weight regain. Other studies have demonstrated that while obesity rates are increasing, their connection to lowered mortality might not tell the whole story, with some showing that fitness levels are a more accurate predictor of health than body mass index.

What is for certain is the ongoing presence of prejudice and stigmatization directed at the fat; discrimination that has been shown to negatively impact mental health, careers, relationships and even medical care. And yet for all the attention paid to supposedly gluttonous Americans who don’t know how to stop eating, much less time has been spent on regulating or even criticizing the practices of the food and beverage industry that has steadily increased the levels of sugar, salt, and fat found in the average American’s diet throughout the past few decades.

For public health experts aware of these nuances, it’s precarious ground to navigate: trying to promote and create policies that can combat the very real problem of obesity but without shaming and alienating those most impacted by it, especially children. One of their major hurdles, as showcased by a new study published in Childhood Obesity, is in making parents even aware of their child’s weight issues in the first place.


Using data taken from the National Health and Nutrition Examination Survey, the multinational team of researchers examined two different time periods, 1988 to 1994 and 2007 to 2012. They compared parents’ responses to a question asking whether they considered their child overweight, underweight, or just about the right weight, with the children in their sample aged 3 to 5. They then judged the parents’ accuracy via reported information about their child’s weight and height. Even though the surveys were taken 20 years apart, and children have become much heavier in that time span, the level of inaccuracy found was strikingly similar. "Percentages of parents who inappropriately perceived their overweight child as just about the right weight was 96.6 percent and 94.9 percent for the early and recent survey, respectively," the authors wrote.

Parents in the most recent survey were only slightly better at telling whether their child was obese, with an inaccuracy rate of 78 percent found. Noting that previous research has shown similar results, the authors were nonetheless alarmed when further breaking down the demographics of the survey participants, finding that lower income and African-American parents had the most difficulty guessing correctly. "This was especially concerning because African-American and low-income children in the U.S. have the highest rates of obesity," said lead author Dr. Dustin Duncan of the NYU Langone Medical Center in a press release.

Duncan, also an associate professor in the Department of Population Health at NYU, went on to explain that one likely reason for their results is that people, not just parents, often look to others when judging characteristics like weight. As the average American has become heavier, so too has our perception of what healthy weight looks like in comparison. And other research has found a similar misjudging effect when asking people to guess their weight themselves. But the authors also believe that their results demonstrate a profound lack of communication between the medical community and parents, as many had little understanding of what the standard weight and height for their child should be.

In an accompanying editorial for Childhood Obesity, Editor-in-chief Dr. David Katz lamented what he has coined "oblivobesity." "We do not always fix what we know to be broken, but we virtually never fix what we are overlooking — whether at the personal level or that of our culture," he wrote. Katz also noted that weight obliviousness can cut both ways, with normal weight individuals, especially women, judging themselves to be too heavy and going on unnecessary diets or developing eating disorders.

Still, he believes the answer will not be found by burying our collective heads in the sand and shying away from conversations about weight with our children, explaining that school initiatives to inform parents of their child's weight have been met with outrage and accusations of shaming both parent and child. But it’s a conversation that must involve a careful understanding of the larger societal context surrounding weight, Katz adds, "There is an alternative to oblivobesity that does not involve obsession with weight; that does not blame the victim; that does not ostracize the overweight child; and that does not imply bathroom scales measure anything important about human worth. That alternative is a focus on health and family, love, and the long term."

For both expert and parent, it appears to be a conversation that has to happen sooner rather than later.

Source: Duncan D, Hansen A, Wang W, et al. Change in Misperception of Child's Body Weight among Parents of American Preschool Children. Childhood Obesity. 2015.