Parental Misperceptions of Children's Weight and Their Association With Feeding Practices

To examine associations between parental perceptions of child weight and feeding practices.

Cross-sectional study using parent and self-reported questionnaires to collect data on parental perceptions, feeding practices, demographic characteristics, and self-reported anthropometric data.

Elementary schools in Hsinchu County, Taiwan.

A total of 2,507 parent-child dyads with children aged 10-11 years in Taiwan.

Primary variables included parental weight perceptions, feeding practices (monitoring, pressure-to-eat [PE], restriction, and reward-based practices), sociodemographic characteristics, and anthropometric measurements.

Linear regression models analyzed associations between feeding practices and parental underestimation of child weight, with separate models for fathers and mothers, adjusting for child sex and socioeconomic status. Multiple imputation addressed missing data.

Parental underestimation of child weight was common (fathers: 28.9%, mothers: 26.9%), particularly for children with overweight or obesity. Both parents showed increased PE practices when underestimating weight (fathers: coefficient = 0.24; mothers: coefficient = 0.26; P < 0.001). Mothers reduced restriction (coefficient = -0.10, P = 0.02) and used more PE with sons (coefficient = 0.15, P < 0.001), whereas fathers employed more reward-based practices with daughters (coefficient = 0.14, P = 0.005).

Findings reveal distinct gender differences in how parental weight perceptions relate to feeding practices. Health care providers should consider these patterns when developing family-based weight management strategies.