Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Is obesity becoming the new normal? Age, gender and racial/ethnic differences in parental misperception of obesity as being ‘About the Right Weight’



Younger children, non-Hispanic Black and male children who are overweight (body mass index (BMI) 85th percentile) are at greater risk for being misperceived by their parents as having a healthy or normal weight, but less is known about the risk for weight misperception in the subpopulation of children with obesity (BMI95th percentile). We assessed the gender, age and racial/ethnic differences in parental misperception of healthy or normal weight status in children with obesity.


We analyzed the data of 1445 children and adolescents aged 6–15 years with obesity obtained from the National Health and Nutrition Examination Surveys conducted from 2005 to 2012. Parental perception of the child’s weight was obtained during an in-home interview. Anthropometric data on body weight were collected from the children during their physical and used to calculate gender and age-specific BMI percentiles. Logistic regression was used to calculate the adjusted odds ratios for parental misperception of their child’s obesity as being ‘about the right weight’, using parents who perceived their children with obesity as being ‘overweight’ for reference.


Boys aged 6–15 years with obesity were more likely to be misperceived as being ‘about the right weight’ by their parents (adjusted odds ratio (aOR): 1.40 (1.12–1.76) vs girls, P=0.0038). The subpopulations of children with obesity who were significantly less likely to be misperceived included girls aged 11–15 years (aOR: 0.46 (0.29–0.74) vs girls 6–10 years, P=0.0016) and Hispanic males (aOR: 0.58 (0.36–0.93) vs White males, P=0.02).


Significant age differences in the odds for parental misclassification of obesity as ‘about the right weight’ were detected in female children, but not males. Hispanic males with obesity were significantly less likely to be misperceived as being ‘about the right weight’ when compared with their non-Hispanic White peers.

Your institute does not have access to this article

Access options

Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.

Figure 1


  1. Taveras EM, Baidal JAW . Childhood obesity: shifting the focus to early prevention. Arch Pediatr Adolesc Med 2012; 166: 1179–1181.

    Article  Google Scholar 

  2. West DS, Raczynski JM, Phillips MM, Bursac Z, Heath Gauss C, Montgomery BEE . Parental recognition of overweight in school-age children. Obesity 2008; 16: 630–636.

    Article  Google Scholar 

  3. Israel AC, Solotar LC, Zimand E . An investigation of two parental involvement roles in the treatment of obese children. Int J Eat Disord 1990; 9: 557–564.

    Article  Google Scholar 

  4. Nader PR, O’Brien M, Houts R, Bradley R, Belsky J, Crosnoe R et al. Identifying risk for obesity in early childhood. Pediatrics 2006; 118: e594–e601.

    Article  Google Scholar 

  5. Guo SS, Wu W, Chumlea WC, Roche AF . Predicting overweight and obesity in adulthood from body mass index values in childhood and adolescence. Am J Clin Nutr 2002; 76: 653–658.

    CAS  Article  Google Scholar 

  6. Etelson D, Brand DA, Patrick PA, Shirali A . Childhood obesity: do parents recognize this health risk? Obes Res 2003; 11: 1362–1368.

    Article  Google Scholar 

  7. Barlow SE . Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics 2007; 120 Suppl: S164–S192.

    Article  Google Scholar 

  8. Chen H-Y, Lemon SC, Pagoto SL, Barton BA, Lapane KL, Goldberg RJ . Personal and parental weight misperception and self-reported attempted weight loss in US children and adolescents, National Health and Nutrition Examination Survey, 2007-2008 and 2009-2010. Prev Chronic Dis 2014; 11: E132.

    Article  Google Scholar 

  9. Hansen AR, Duncan DT, Tarasenko YN, Yan F, Zhang J . Generational shift in parental perceptions of overweight among school-aged children. Pediatrics 2014; 134: 481–488.

    Article  Google Scholar 

  10. Maynard LM, Galuska DA, Blanck HM, Serdula MK . Maternal perceptions of weight status of children. Pediatrics 2003; 111 (5 Part 2): 1226–1231.

    PubMed  Google Scholar 

  11. Tschamler JM, Conn KM, Cook SR, Halterman JS . Underestimation of children’s weight status: views of parents in an urban community. Clin Pediatr (Phila) 2010; 49: 470–476.

    Article  Google Scholar 

  12. Myers S, Vargas Z . Parental perceptions of the preschool obese child. Pediatr Nurs 2000; 26: 23–30.

    CAS  PubMed  Google Scholar 

  13. Eckstein KC, Mikhail LM, Ariza AJ, Thomson JS, Millard SC, Binns HJ . Parents’ perceptions of their child's weight and health. Pediatrics 2006; 117: 681–690.

    Article  Google Scholar 

  14. Jain A, Sherman SN, Chamberlin LA, Carter Y, Powers SW, Whitaker RC . Why don’t low-income mothers worry about their preschoolers being overweight? Pediatrics 2001; 107: 1138–1146.

    CAS  Article  Google Scholar 

  15. National Center for Health Statistics. Overview: NHANES Sample Design [Internet]. Available from

  16. Kuczmarski RJ, Ogden CL, Guo SS, Grummer-Strawn LM, Flegal KM, Mei Z et al. 2000 CDC Growth Charts for the United States: Methods and Development. Vital Heal Stat 11 2002; 246: 1–190.

    Google Scholar 

  17. De La OA, Jordan K, Ortiz K, Moyer-Mileur L, Stoddard G, Friedrichs M et al. Do parents accurately perceive their child’s weight status? J Pediatr Heal Care 2009; 23: 216–221.

    Article  Google Scholar 

  18. Lundahl A, Kidwell KM, Nelson TD . Parental underestimates of child weight: a meta-analysis. Pediatrics 2014; 133: e689–e703.

    Article  Google Scholar 

  19. Katz DL . Oblivobesity: looking over the overweight that parents keep overlooking. Child Obes 2015; 11: 225–226.

    Article  Google Scholar 

  20. Olvera N, Suminski R, Power TG . Intergenerational perceptions of body image in hispanics: role of BMI, gender, and acculturation. Obes Res 2005; 13: 1970–1979.

    Article  Google Scholar 

  21. Lewinsohn PM, Striegel-Moore RH, Seeley JR . Epidemiology and natural course of eating disorders in young women from adolescence to young adulthood. J Am Acad Child Adolesc Psychiatry 2000; 39: 1284–1292.

    CAS  Article  Google Scholar 

  22. Fairburn CG, Harrison PJ . Eating disorders. Lancet 2003; 361: 407–416.

    Article  Google Scholar 

  23. Biro FM, Greenspan LC, Galvez MP, Pinney SM, Teitelbaum S, Windham GC et al. Onset of breast development in a longitudinal cohort. Pediatrics 2013; 132: 1019–1027.

    Article  Google Scholar 

  24. McCabe MP, Ricciardelli LA . Parent, peer, and media influences on body image and strategies to both increase and decrease body size among adolescent boys and girls. Adolescence 2001; 36: 224–240.

    Google Scholar 

  25. Field AE, Camargo CA, Taylor CB, Berkey CS, Roberts SB, Colditz GA . Peer, parent, and media influences on the development of weight concerns and frequent dieting among preadolescent and adolescent girls and boys. Pediatrics 2001; 107: 54–60.

    CAS  Article  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to K R Sonneville.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Additional information

Author contributions

JPT had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. JPT and KRS were involved in the design and conduct of the study. Collection, management, analysis and interpretation of the data were also done by JPT and KRS. All the authors were involved in the preparation, review or approval of the manuscript. The decision to submit the manuscript for publication was also taken by all the authors.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Twarog, J., Politis, M., Woods, E. et al. Is obesity becoming the new normal? Age, gender and racial/ethnic differences in parental misperception of obesity as being ‘About the Right Weight’. Int J Obes 40, 1051–1055 (2016).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:

Further reading


Quick links