Article Text

  1. J. G. Sayat,
  2. M. V. Louthan,
  3. S. M. Franco,
  4. J. A. Theriot
  1. Department of Pediatrics, University of Louisville


Background Obesity has reached epidemic proportions in the United States. Previous research has shown that mothers of overweight children have difficulty identifying their children as overweight.

Objective To determine and evaluate the associations of the actual and maternal perception of the child's weight.

Methods A prospective sample of mothers of children aged 2-17 years who presented at two inner-city, university affiliated pediatric clinics were surveyed on whether they thought their child's weight was “just right,” “too light,” or “too heavy.” Mothers were asked to provide their own height and weight as well as that of the child's father if known. Other demographic variables were also collected. The height and weight of each child were measured and the BMI calculated for all three family members. Categories for adult BMI were as follows: < 25 = normal, 25-29.9 = overweight, ≥ 30 = obese. For pediatric BMI, less than 5% = underweight, 85-95% = at risk for overweight, > 95% = overweight.

Results The mothers of 504 children were surveyed (79.8% African-American, 91.9% Medicaid, 52.8% male). For mothers, 157 (31%) were overweight and 215 (42.7%) were obese. For fathers, 174 (34.5%) were overweight, 161 (32%) were obese; data for 27 (5%) were not available. For children, 88 (17.5%) were at risk for being overweight, and 113 (22.4%) were overweight. If either mother (OR = 2.1; 95% CI 1.4-3.2, p < .001) or father (OR = 2.5; 95% CI 1.6-3.8, p < .001) was obese, their child was also more likely to be overweight. There was no difference in the accuracy of maternal perception when comparing overweight with nonoverweight children. However, when comparing overweight boys to girls, the boys were less likely to be accurately perceived by their mothers as too heavy (OR = 0.28; 95% CI 0.12-0.67, p = .003). Also, children less than eight years were less likely to be accurately perceived by their mothers (OR = .0451; 95% CI 0.31-0.656, p < .01) as overweight.

Conclusions Obesity is a family problem, which may be complicated by inaccurate maternal perceptions. Young and male children are particularly susceptible to inaccurate perceptions. Families should be educated early on the risks and weight status of their children.

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