Children’s, Their Guardians’, and Health Care Professionals’ Perceptions of Child Overweight in Relation to Children’s Weight Loss Attempts

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Publication Date


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American Journal of Health Promotion






Purpose: To examine accuracy of children's, their guardians', and health care professionals' (HCPs') perceptions of child overweight and obesity, the degree of agreement between their perceptions, and relationships with weight loss attempts among overweight or obese children.

Design: Cross-sectional study using 2005–2010 National Health and Nutrition Examination Survey.

Setting: United States.

Subjects: Out of 4691 children and adolescents, ages 8 to 15 years, 16.4% were overweight (body mass index [BMI] percentiles 85–94.99) and 19.3% were obese (BMI percentiles ≥95).

Measures: Age and sex-specific BMI percentiles; responses of adult proxies (guardians) on whether they considered their child overweight and whether an HCP had ever told them that their child was overweight; responses of children and adolescents on their self-perceived weight status and whether they were trying to lose weight; children's and guardians' socio-demographic characteristics.

Analysis: Weighted percentages; sensitivities and Cohen's kappas; adjusted prevalence ratios.

Results: Children, their guardians, and HCPs underestimated child's actual overweight or obesity status. Little agreement existed between overweight or obese children, their parents, and HCPs on whether these children were overweight or obese. Overweight and obese children perceived as such by themselves, their guardians, and HCPs were 88% and 32%, respectively, more likely to attempt weight loss based on multivariable analyses.

Conclusion: Accurate and shared perceptions of adiposity in children and adolescents between children themselves, their guardians, and HCPs are positively associated with weight loss attempts among overweight or obese children in the United States.