Do parents care if kids are fat?

There's no harm in allowing kids a few extra cookies, a box of candy canes, some fudge and an extra helping of turkey and mashed potatoes during the holidays, right? For some kids, a few extra treats in moderation during the holiday season is harmless, but for others who indulge year-round and get little exercise, extra holiday indulgences only add to weight gain and the prevalence of childhood obesity in the United States.

The problem, say researchers at University of Michigan C.S. Mott Children's Hospital, is that large numbers of parents fail to recognize that their children are overweight or obese, and therefore may be less inclined to modify their children's diet and activity levels.

According to a new report by the C.S. Mott Children's Hospital National Poll on Children's Health, more than 40% of parents with obese children ages 6 to 11 describe their child not as obese, but as "about the right weight."

In fact, the report finds only 13% of parents with obese children ages 6 to 11 rate their child as being very overweight, compared with 31% of parents with obese children ages 12 to 17. In addition, less than 10% of parents with obese children ages 6-11 say they are "very concerned" about their child's weight.

While most parents agree childhood obesity is a major health issue, many underestimate their own children's weight and fail to take corrective steps to manage weight gain. Without intervention, childhood obesity can take a hefty toll on a person's life-long health.

Address the problem early on

"It is critical to address obesity in the childhood years - at home, and in schools and other community settings," says Matthew M. Davis, M.D., M.A.P.P., director of the National Poll on Children's Health. "But in order to address childhood obesity at home, parents must first recognize that a child is not at a healthy weight for their height. Parents also must be concerned enough to want to do something about their children's obesity."

One of the greatest challenges for parents is that children's obesity may not be easy to judge subjectively, he says. Obesity is based on a child's body mass index, or BMI. When a child's BMI is at or higher than the 95th percentile for children who are the same age and gender, the child is obese. For example, a six-year-old boy who is average height (116cm) would be considered obese if he weighs 25kg or more.

Based on results from the latest report from the National Poll on Children's Health, Davis says parents may under-estimate their children's weight, and/or over-estimate their children's height. Parent-reported height and weight for the poll indicate that 15% of children ages 6 to 11, and 10% of children ages 12 to 17, are obese. Overall, 25% of children in 2007 were reported as being either obese or overweight.

Stark mismatch

These parent-reported estimates, however, fall short of previous data on childhood obesity and overweight obtained through national studies. The studies - in which children's height and weight were measured in person - found that 35% of U.S. children ages 6 to 17 are obese or overweight

Even with this underestimate, Davis says there is a stark mismatch between children's obesity and parents' perception of whether their children's weight is appropriate.

Using data from a national online survey conducted in July and August in collaboration with Knowledge Networks Inc., the National Poll on Children's Health sought to learn more about not only parent-reported weight and height, but also parental perception and concerns about their children's weight.

The survey was administered to a random sample of 2,060 adults, ages 18 and older, who are a part of Knowledge Network's online KnowledgePanelSM. The sample was subsequently weighted to reflect U.S. population figures from the U.S. Census Bureau. About two-thirds of the sample was parents.

Results show that only 7% of parents with obese children ages 6 to 11 are very concerned about their children's weight. In comparison, 46% of parents with obese children ages 12 to 17 say they are very concerned.

Across the country, parents' concern about their children's weight also varied by region. Only 13% of parents living in the Midwest were very concerned about their obese children's weight, while 37% of those living in the Northeast were very concerned. Nearly half of all parents in the Midwest and West reported they are either not at all concerned, or not too concerned about their obese children's weight, according to the National Poll on Children's Health.

Putting your child's health at risk

Parents' lack of concern about their children's weight can have serious health implications. According to poll results, obese children are more than twice as likely as healthy weight children to have asthma. In addition, Davis says, parents who do not recognize obesity or are not worried about their children's weight may not take the appropriate steps to help their children lead a healthier lifestyle.

It also could have serious implications on the health of a community. "Without parents' help, school and community efforts to mitigate the childhood obesity epidemic may have limited success as well," says Davis, associate professor of general paediatrics and internal medicine at the U-M Medical School, and associate professor of public policy at the U-M Gerald R. Ford School of Public Policy.

Fortunately, health care providers can play an important role in helping parents to recognize obesity, and take steps to modify a child's diet and activity levels. The National Poll on Children's Health found that 84% of parents believe it is very important for doctors to address obesity with obese adolescents during routine check-ups. "Parents willingness to discuss obesity at their children's medical appointments indicates that many parents view doctors as a welcome source of information about obesity interventions for children," says Davis.

Report highlights

• One-quarter of U.S. children ages 6 to 17 are either obese or overweight, based on parents; report of their children's height and weight.
• Less than 10% of parents of obese children ages 6 to 11 are very concerned about their children's weight.
• More than 40% of parents with obese children ages 6 to 11 perceive their children's weight status as "about the right weight."

Obese children are more than twice as likely to have asthma as healthy weight children.

For the complete report, visit the C.S. Mott Children's Hospital National Poll on Children's Health at Http://www.chear.umich.edu.