PEDIATRICS Vol. 106 No. 6 December 2000, pp. 1380-1386
Maternal Perceptions of Overweight Preschool Children
Received Sep 22, 1999; accepted Apr 4, 2000.
, and
From the * Department of Pediatrics, Children's Hospital
Medical Center; and the University of Cincinnati College of
Medicine, Cincinnati, Ohio.
Context. Childhood obesity is a major public health problem, and prevention efforts should begin early in life and involve parents.
Objective. To determine what factors are associated with mothers' failure to perceive when their preschool children are overweight.
Design. Cross-sectional survey.
Settings. Offices of private pediatricians and clinics of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).
Participants. Six hundred twenty-two mothers with children 23 to 60 months of age.
Main Outcome Measures. Maternal demographic variables, maternal self-reported height and weight, and children's measured height and weight. Mothers were asked whether they considered themselves or their children overweight.
Results. Forty-five percent of mothers had low education
(high school degree or less) and 55% had high education (some college
or more). Obesity (body mass index: 
30 kg/m2) was more
common in the low education group of mothers (30% vs 17%), and their
children tended to be more overweight (weight-for-height percentile:
90th; 19% vs 14%). Ninety-five percent of obese mothers believed
that they were overweight, with no difference between education groups.
However, 79% of mothers failed to perceive their overweight child as
overweight. Among the 99 mothers with overweight children, low maternal
education was associated with a failure to perceive their children as
overweight after adjusting for low family income (
185% of poverty),
maternal obesity, age, and smoking plus the child's age, race, and
gender (adjusted odds ratio: 6.2; 95% confidence interval:
1.7-22.5).
Conclusions. Obesity was more common in mothers with less education as well as in their children. Nearly all of the obese mothers regarded themselves as overweight. However, the majority of mothers did not view their overweight children as overweight, and this misperception was more common in mothers with less education. Childhood obesity prevention efforts are unlikely to be successful without a better understanding of how mothers perceive the problem of overweight in their preschool children. Key words: obesity, body weight, mothers, child, preschool, mother-child relations, educational status, weight perception.
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