How Parents Perceive Their Children's Body Weight: Insights from a Sample of Schoolchildren from Vienna, Austria

Effective school-based childhood obesity prevention strategies should include parental involvement. In the EDDY ("Effect of sports and diet training to prevent obesity and secondary diseases and to influence young children's lifestyle") program, we aimed to describe parental perceptions of children's body weight in a sample of schoolchildren from Vienna, Austria.

A cross-sectional analysis, including 128 children from the third grade in three Viennese primary schools, was conducted. A self-administered questionnaire was used to collect sociodemographic data and parentally reported weight and height. Parental perception of the child's weight status was assessed using the question, "In your opinion, you would describe your child as being". Children's nutritional status was assessed through measurements.

Almost 15% of the children had obesity. The median SDS-BMI was 0.39 (-1.00-2.83) and 0.21 (-1.39-2.47) for girls and boys, respectively. More mothers of girls had overweight/obesity compared to mothers of boys (59.2% vs. 41.1%, p = 0.05). Almost half (48.4%) of the parents underestimated their child's weight. The percentage of mothers with overweight/obesity was higher in the group that underestimated their child's weight (59.3% vs. 37.7%, p = 0.018). Parents perceived 59.4% of the children as having a normal weight, while BMI classification indicated that 71.9% had a normal weight. Misperception was higher among children who were overweight (75%) and obese (89.5%). Parents of children with a normal weight were less likely to underestimate [Adjusted OR = 0.16 (95% CI: 0.050-0.49)].

The prevalence of misperception was high, especially for children with overweight or obesity. These findings highlight the need to incorporate children's adequate weight recognition into the EDDY program as part of parents' content.