NEW YORK (Reuters Health) - The ability of a mother to identify a weight problem in her child appears to be dependent on her own weight, with overweight mothers tending to underestimate her child's weight. On the other hand, a mother's ability to correctly determine the weight status of a child who is unrelated to her appears to depend on her socioeconomic level, new research in Pediatrics shows.
The findings present a challenge for physicians working with overweight kids and their parents, Dr. Petra Warschburger and Katja Kroller of the University of Potsdam in Germany point out. "The first step for parents is to recognize and accept that their child is overweight or, at least, threatened by overweight and to recognize overweight in this particular age group as a significant and severe health risk," the authors say.
Many studies have found that parents have difficulty determining whether or not their own children are overweight, Warschburger and Kroller write. To better understand why, they had 219 mothers of children 3 to 6 years old look at four sets of silhouettes. Each group included seven different silhouettes representing age- and gender-specific body mass index, and included two underweight children, five normal-weight children, one overweight child and an obese child.
Women in the study were either overweight, came from a low socioeconomic background, or had at least one overweight child.
About two thirds of the participants were able to correctly identify the overweight silhouettes. But just 40.3 percent chose the silhouette that accurately represented their own child's weight status.
Study participants also were asked which of the silhouettes were at increased risk for physical and mental health problems; to answer correctly, they would have had to choose the two overweight silhouettes. But just 48.8 percent stated that the overweight silhouettes were at greater risk for physical health problems, while 38.7 percent saw the overweight silhouettes as indicating an increased risk of mental health problems.
Overweight moms were actually more likely to answer the mental health question correctly, possibly because they themselves "experience weight-related emotional strain," the researchers suggest.
The ability to identify an unrelated child's weight status had nothing to do with whether or not a mother could gauge her own child's weight correctly.
"We believe that the mothers' perception of their own child is more affected by emotional factors than a universal misperception of overweight children," the researchers say. "The estimation of unrelated children, on the other hand, is based more on 'cognitive' factors such as knowledge about weight and body image, which are highly associated with the educational status."
Warschburger and Kroller suggest pediatricians and dietitians use a type of counseling called motivational interviewing to help parents with children at risk of being overweight.
This technique involves working with someone to explore his or her mixed feelings about a particular issue and resolve that ambivalence. "It is important," they add, "that health professionals not only give feedback about the child's health status but also support the parents in changing their child's feeding environment."
SOURCE: Pediatrics, July 2009.