Preferred Child Body Size and Parental Underestimation of Child Weight in Mexican-American Families

Lauri A. Pasch, Carlos Penilla, Jeanne M. Tschann, Suzanna M. Martinez, Julianna Deardorff, Cynthia L. de Groat, Steven E. Gregorich, Elena Flores, Nancy F. Butte, Louise C. Greenspan

Objective To determine whether parents who prefer a heavier child would underestimate their child's weight more than those who prefer a leaner child. Methods Participants were Mexican-American families (312 mothers, 173 fathers, and 312 children ages 8-10) who were interviewed and had height and weight measurements. Parents reported their preferred child body size and their perceptions of their child's weight. Parents' underestimation of their child's weight was calculated as the standardized difference between parent's perception of their child's weight and the child's body mass index (BMI) z-score. Demographic factors and parental BMI were also assessed. Results Although 50 % of children were overweight or obese, only 11 % of mothers and 10 % of fathers perceived their children as being somewhat or very overweight. Multiple regressions controlling for covariates (parental BMI and child age) showed that parents who preferred a heavier child body size underestimated their children's weight more, compared to those who preferred a leaner child (β for mothers = .13, p < .03; β for fathers = .17, p < .03). Conclusions for Practice Parents who preferred a heavier child body size underestimated their child's weight to a greater degree than parents who preferred a leaner child. Attempts by pediatricians to correct parents' misperceptions about child weight may damage rapport and ultimately fail if the misperception is actually a reflection of parents' preferences, which may not be readily amenable to change. Future research should address optimal methods of communication about child overweight which take into account parent preferences.