One Third of Children Misperceive Their Weight Status

Lara C. Pullen, PhD

July 23, 2014

Approximately 30% of children between the ages of 8 and 15 years misperceive their weight status, according to a new analysis of data from the National Health and Nutrition Examination Survey, 2005 to 2012.

In particular, Mexican-American and non-Hispanic black children are more likely than non-Hispanic white children to misperceive their weight status, report Neda Sarafrazi, PhD, from the Centers for Disease Control and Prevention's (CDC's) National Center for Health Statistics, Hyattsville, Maryland, and colleagues in a news brief published online July 23.

They report that 81% of overweight boys and 71% of overweight girls believe they are of normal weight. Nearly 48% of obese boys and 36% of obese girls think that they are about the right weight.

All told, an estimated 9.1 million children and adolescents in the United States have an inaccurate understanding of their weight status. Weight status misperception was significantly higher among children aged 8 to 11 years (33%) than among adolescents aged 12 to 15 years (27%). Weight misperception was also significantly higher among lower-income families (32.5%) than among higher-income families (26.3%).

Childhood obesity is associated with many adverse health outcomes in adulthood. Children who accurately know their weight status are more likely to appropriately modify their behaviors. Thus, Elizabeth Parks Prout, MD, medical director of the adolescent bariatric program of the Children's Hospital of Philadelphia, Pennsylvania, suggests pediatricians pay attention to the actual numbers associated with obesity and talk about those numbers with families.

Emphasizing how important the actual numbers are for children and adolescents, Dr. Prout notes that 70% of pediatricians get obesity status wrong when they just look at a child. "We can't go based upon how people look," she told Medscape Medical News.

The study also identifies, however, certain populations that deserve added attention. Overall, 34.0% of Mexican-American children aged 8 to 15 years misperceived their weight status, as did 34.4% of non-Hispanic blacks, both of which are significantly higher percentages than the 27.7% of non-Hispanic white children who misperceived their weight status.

Dr. Prout also points out that the fastest-rising group for obesity is boys. The general population, however, tends to focus obesity efforts on girls, often neglecting the trend in boys.

The National Health and Nutrition Examination Survey is a cross-sectional survey of the civilian noninstitutionalized population. Sampling is performed through a complex, multistage design, and data are released in 2-year cycles.

Nearly 17% of children and adolescents were obese in 2011 to 2012. Children and adolescents were defined as having normal weight if their body mass index fell within the 5th and 85th percentiles of the 2000 sex-specific CDC growth chart. Children were described as overweight if they were between the 85th and 95th percentiles. Obese children had a body mass index that was greater than or equal to the 95th percentile on the 2000 CDC growth chart.

The authors and Dr. Prout have disclosed no relevant financial relationships.

"Perception of Weight Status in U.S. Children and Adolescents Aged 8–15 Years, 2005–2012." NCHS Data Brief 158. Published online July 23, 2014. Full text

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