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

INTRODUCTION: 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 (BMI. >= 95th percentile). We assessed the gender, age and racial/ethnic differences in parental misperception of healthy or normal weight status in children with obesity. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.