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Updated: Apr 25, 2026

Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Generational shift in parental perceptions of overweight among school-aged children
Andrew R Hansen1, Dustin T Duncan2, Yelena N Tarasenko3
1Departments of Community Health Behavior and Education.
Insights
Parents are increasingly failing to recognize when their children are overweight, indicating a shift in social norms regarding childhood weight. This trend may impact family readiness to adopt healthy behaviors.
Area of Science:
- Pediatric Health
- Public Health
- Sociology
Background:
- Parental perceptions of a child's weight status are crucial for family engagement in healthy behaviors.
- This study examines how parental perceptions of children's weight have changed across generations.
Purpose of the Study:
- To investigate generational shifts in parental perceptions of children's weight status.
- To understand how these perceptions have evolved over time and their implications for public health.
Main Methods:
- Utilized data from the National Health and Nutrition Examination Survey (NHANES) from 1988-1994 and 2005-2010.
- Analyzed responses from parents regarding their perception of their child's weight (ages 6-11) against CDC growth charts.
- Employed Poisson regression to assess changes in the probability of parents correctly identifying their child's overweight status.
Main Results:
- The threshold for parental perception of overweight status has significantly shifted to a higher BMI percentile over time.
- Children perceived as overweight had higher mean BMI z-scores in the recent survey, particularly those from low-income families and African American children.
- The accuracy of parental identification of overweight/obese children decreased by 24% between the two survey periods.
Conclusions:
- Overweight and obese children were less likely to be perceived as overweight by parents in the more recent survey.
- This declining accuracy suggests a potential generational shift in societal norms surrounding body weight.
- The findings highlight a growing disconnect between actual child weight status and parental perception, potentially affecting interventions for childhood obesity.
Background:
Parental perceptions of child's weight status may influence family readiness to foster healthy behaviors. This study investigated the generational shifting of parental perceptions about children's weight.
Methods:
Data were collected in the NHANES 1988-1994 (n = 2871) and 2005-2010 (n = 3202). Parents, mainly mothers, were asked whether they considered their child, ages 6 to 11 years, to be overweight, underweight, or just about the right weight. The Centers for Disease Control and Prevention 2000 growth chart was used for reference. We ran Poisson regression to estimate the probability ratio between the 2 surveys for parents perceiving their child as overweight after controlling for actual weight.
Results:
The 10th percentile of BMI z scores for children who were parentally perceived as overweight shifted with statistical significance from 84th percentile of reference population in the early survey to 91st percentile of reference population in the recent survey (P < .05). The mean z score of children parentally perceived as overweight also increased between surveys with the largest increase among children from poor families (from 1.60 [SE: 0.20] to 1.98 [0.08], P < .05), followed by African Americans (from 1.65 [0.09] to 2.02 [0.05], P < .05). The probability of overweight/obese children being correctly perceived as overweight by the parents declined by 24% between surveys (probability ratio = 0.76 [95% confidence interval: 0.67-0.87]).
Conclusions:
Overweight/obese children were less likely to be perceived as overweight in the recent survey compared with peers of similar weight but surveyed 10+ years earlier. The declining tendency among parents to perceive overweight children appropriately may indicate a generational shift in social norms related to body weight.
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