Parents Likely to Listen to Pediatricians about Children's Weight

Parents of pre-school age children are more likely to underestimate their child’s weight if a pediatrician does not directly communicate that their child is overweight or gaining weight too fast, a new study from researchers at the University of South Florida and Johns Hopkins University, led by Raquel Hernandez, MD, MPH, reveals.

Hernandez, assistant professor of pediatrics at USF and lead author of the study published in Clinical Pediatrics, and colleagues interviewed 150 parents of preschool children ages 2-5 from July 2008 to April 2009 during well visits at an academic-based clinic. They found that “the absence of a pediatrician’s comment was the strongest predictor that a parent of an overweight or obese child would misclassify their child’s body image. These parents reported that their own child’s current weight was the same or lighter than that of a healthy-weight preschooler,” she said.

Other findings were as follows:

- Among all respondents, less than 8% recalled ever being told by their pediatrician that their child was gaining weight too fast or overweight. A larger proportion of parents with overweight or obese children reported hearing this from a pediatrician—10% and 30%, respectively.

- While nearly one in three preschoolers in the study was overweight or obese, 83% of all parents reported their children as “about the right weight.” More than half the parents of obese children cited their child was “about the right weight.”

- Parents of overweight preschoolers were much more likely to underestimate their children’s weight (89.6%) than parents of obese children (45.5%). In fact, 20% of these parents indicated that an image heavier than their child’s reflected a healthy preschooler.”

Although Hernandez adds that pediatricians may be reluctant to discuss a child’s weight for several reasons—because they fear offending parents, or because of the lack of specific clinical testing recommendations like blood sugar and cholesterol and lifestyle recommendations for very young overweight and obese children—she believes that pediatricians should not hesitate, because most parents in the study overwhelmingly reported that they would value a physician’s advice. Additionally, early interventions may be an important opportunity to help children before eating and exercise habits are set, and when it is easier to lose weight.

“Weight is part of early childhood growth and development that should be on a parent’s radar screen,” Hernandez said. “Even when it’s an uncomfortable subject, pediatricians need to raise the issues of long-term health risk, nutrition and behavioral changes with parents whose children are overweight or obese—because clearly they will listen to us.”