More than 50% of parents fail to recognise that their children may be seriously overweight – and many health professionals share this misperception, according to research* presented at the European Congress on Obesity in Glasgow.
“Despite attempts to raise public awareness of the obesity problem, our findings indicate that underestimation of child higher weight status is very common,” said the project’s leader, Abrar Alshahrani, of Nottingham University.
Commenting on the findings Royal College of GP’s (RCGP) chair Professor Helen Stokes-Lampard, said: "This study shows how underestimation is prevalent across the board – including among healthcare professionals – and highlights the importance of taking accurate measurements, so that appropriate and consistent interventions can be implemented to support a child to lose weight and live a healthier lifestyle.
"It also emphasises how vital it is to be frank about weight from an early age as forging healthy behaviours in early life will have a very real impact on a patient's long-term health and wellbeing into adulthood. Childhood obesity is one of the most serious health challenges of our time and one that mustn't be swept under the carpet."
The team analysed evidence from 87 previous studies that were conducted worldwide between 2000 and 2018, involving 24,774 children aged up to 19 years old and their parents.
In the study Alshahrani and colleagues analysed the assessments of parents, caregivers and healthcare professionals of children’s weights and compared these with recognised medical standards for defining overweight, including measurements of height, weight and circumference of waist and hip.
Results showed that about 55% of parents underestimated the degree to which their children were overweight, while more than a third of children and adolescents also underestimated their own weight status. Healthcare professionals also shared these tendencies.
In addition, parents who were overweight themselves, and with less education, were also less likely to accurately assess their child’s higher weight. The authors noted that ethnicity and cultural norms may also have an effect on parental perceptions, as some cultures prefer a larger body type and may not identify their child as overweight.
Alshahrani said recognition of parents’ and health professionals’ views of children’s weight problems was extremely important: “The first step for a health professional in supporting families is a mutual recognition of higher weight status. This is particularly important for the children themselves, the parents, and the health professionals who look after them. Our study also found a tendency for health professionals to underestimate weight, which suggests that overweight children may not be offered the support they need to ensure good health.”
Professor Stokes-Lampard said that while primary care teams will routinely talk to parents about simple lifestyle changes that can have a positive impact on their children's health, the problem is a society-wide responsibility.
"We need to work with parents, healthcare professionals, teachers, advertisers, food manufacturers, retailers, public health officials and others, in order to evoke genuine change. Now that this finding has been observed, it would be useful to see some research into the reasons why people are more likely to underestimate children's weight, so that we can start properly and effectively addressing the problem.
"Physical activity and lifestyle is a clinical priority for the College and we have developed resources to support GPs and healthcare professionals to have what can often be difficult conversations with patients about their weight, and the weight of their children."
The RCGP has also embarked on a partnership with parkrun UK, which has already seen thousands of patients – including children - take part in local running events in their communities, and it will soon be launching another scheme to support GP practices in encouraging patients to get more active.
*Alsharani AF, Swift DA. Underestimation of weight status in children and adolescents aged 0-19 years old: a systematic review and meta-analysis. Department of Nutritional Science, The University of Nottingham, UK. Abstract PP2.01, present at European Congress on Obesity in Glasgow, April 2019.