Inaccurate reporting of child body weight status by child and caregiver: Implications for primary care providers

This generation of children is the first to have a shorter predicted life span than their parents in more than 200 years, due to substantial increases in childhood obesity (Olshansky et al., 2005). The risks associated with overweight and obesity are at an all-time high and include: increases in medical complications, deteriorating social and emotional functioning, shortened life expectancy and decreased quality of life. In the U.S., childhood obesity is a crisis (Carmona, 2005), with 20% of African-American children in the obese category (BMI >=95; Freeman et al., 2006) and 40% who are either overweight or obese (CDC, 2005).;Accurately recognizing overweight and obesity in children has become imperative to children's health, especially for caregivers as they typically provide and/or prepare meals, are responsible for children's involvement in physical activities such as extracurricular sports, and control the amount of sedentary behavior in which children engage. In addition, caregivers are typically responsible for seeking, initiating, and ensuring adherence to needed medical care for children. If obesity is not accurately identified, linking overweight and obesity to increased health risks may fail to motivate individuals to engage in recommended diet and exercise behaviors. The purpose of this study is to extend and build upon the literature by examining the accuracy in identification of overweight and obesity within a sample of African American caregiver and child reports in an existing dataset. This study examined the role of demographic, psychological, behavioral, and attitudinal variables in predicting accuracy. Descriptive data regarding the sample was also gathered.;The sample included 58 African-American child-caregiver dyads recruited from a University-affiliated pediatric primary care clinic. Caregivers were female and child participants consisted of boys (n = 29) and girls (n = 29) between the ages of 8 and 12 years (M = 10.17 years, SD = 1.45). The average BMI percentile-for-age among children was 72.26 (SD = 29.90), which is within the normal range of weight. However, 48.2% were considered overweight or obese based on WHO criteria (2003; Mode = 98th percentile).;Results indicated that children were more likely than caregivers to be accurate in their reporting of their body weight. Furthermore, male children were more accurate in perceiving body weight status than female children. There was no significant difference by child gender in caregivers' accuracy in reporting child body weight status. The significant predictor of caregiver accuracy within this sample was caregiver's attitude about their child's body weight status. Similarly, the single significant predictor of child accuracy was child's attitude about their body weight status.;Taken together, results of the present study suggest differences in the recognition of childhood overweight and obesity in a sample of African-American children and their caregiver's. This may be related to the role of ethnicity and cultural variables involved in the perception of overweight and obesity, indicating the need for pediatricians to assist caregivers in accurately identifying healthy versus unhealthy weight status in children rather than assuming that the caregiver is aware of the child's body weight status. Pediatricians may also benefit from involving their child patients as much as possible in gathering information and making treatment recommendations as this research demonstrates that children have useful contributions to make to their own health care. Finally, the present research highlights the need for those working within a clinical pediatric setting to develop and implement a culturally sensitive values-based treatment program for overweight and obese African-American children who are at great risk for medical and psychological morbidities, decreased quality of life and a shortened lifespan.