Academic journal article Journal of Eating Disorders

In the Parents' View: Weight Perception Accuracy, Disturbed Eating Patterns and Mental Health Problems among Young Adolescents

Academic journal article Journal of Eating Disorders

In the Parents' View: Weight Perception Accuracy, Disturbed Eating Patterns and Mental Health Problems among Young Adolescents

Article excerpt

Author(s): Liv Sand[sup.1], Bryan Lask[sup.2], Mari Hysing[sup.1] and Kjell Morten Stormark[sup.1]

Background

Weight control in children and adolescents has become an important challenge to public health. Despite efforts to fight the obesity epidemic, a substantial proportion of overweight adolescents are not engaging in appropriate weight reducing behaviors[1], thereby increasing the risk for prolonged obesity and poor emotional well-being into adulthood[2]. In contrast, a growing number of non-overweight adolescents make efforts to reduce their weight by unsupervised diets[3] that may develop into more serious eating pathology. Weight perception has been proposed as an important factor for explaining the relationship between weight status and weight control behavior[4]. An inaccurate weight perception can take the form of both over- and underestimation of personal weight status. Both misperceptions can challenge healthy weight maintenance, as overestimation has been associated with unwarranted and unsafe dieting among adolescents[5], while underestimation among overweight or obese individuals may result in low motivation to reduce excessive weight[6].

Parental attitude and behavior can influence the formation of body image and eating behavior among children and adolescents[7], possibly by modelling effects[8], particularly around meals and initiatives to physical exercise or sedentary activities[9]. Parents' ability to take action with regard to weight problems is again dependent upon being aware of the weight status of their children[10]. An important basis for this awareness is that parents recognize weight deviations in their offspring[11], and addressing parental weight perception seems important in preventing under- and overweight among children and adolescents.

Earlier research on the accuracy of parent's weight perceptions has focused mainly on their recognition of overweight in children. A review concludes that more than 60% of children with overweight were perceived by their parents of being of normal weight[12]. Comparable results have been reported for samples including both children and adolescents with overweight or obesity[13], although it has been suggested that the accuracy of parental weight perception increases with the age of the offspring[14]. There are mixed findings with regard to the offspring's gender, as some studies show that overweight boys are more likely to be underestimated than girls[15], while others show either the opposite[16] or no gender effect[17]. The likelihood of parents' underestimation seem to increase with higher Body Mass Index (BMI) of the offspring[16], and this may increase the risk of maintaining unhealthy eating patterns for children and youth who are already at the upper levels of the weight distribution.

Some studies have also investigated how accurate parents are in estimating the BMI of children who are under- or of normal weight. While parental estimates of children with normal weight were accurate in the vast majority of the cases, nearly half of the underweight children were overestimated[18]. The high frequency of overestimation for underweight children has been replicated by other studies with Swedish[19] and Norwegian[20] samples. Although there are fewer studies on this specific misperception, the high prevalence found so far and possible risks of not recognizing underweight with regard to development and growth[21] make this an important research topic in addition to the underestimation of excessive weight.

Thus, previous research has shown substantial discrepancies between actual and perceived weight reported by parents that parallel the misperceptions among children and adolescents themselves[22]. Parents generally seem to be least accurate for children who differ most from average weight, as they tend to overestimate if the child is underweight and underestimate if the child is overweight[20]. This implies that parents tend to correct from deviations from average weight, and Akerman and colleagues[19] have proposed that this skewedness can be understood as a positivity bias. …

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