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Saturday, December 22, 2007 

March 8, 2006 -- Parents often don't recognize that their children are overw

March 8, 2006 -- Parents often don't recognize that their children are overweight or aren't concerned about those extra pounds, a new study shows.

The study, published in Pediatrics, included 223 children. Nearly 40% of the kids were overweight or at risk of becoming overweight.

"Few parents of overweight and at-risk-of-overweight children recognized their child as overweight or were worried," write Kathryn Eckstein, MD, and colleagues, noting that past studies have had similar results.

Eckstein's team wants that pattern to change, since recognizing a weight issue is the first step toward treatment. So they came up with several ways parents can take control of the touchy topic of kids' weight.

Getting Visual

Eckstein worked on the study while at the University of Tennessee's medical school. She's now in Boston at the Harvard Longwood Psychiatry Residency Training Program.

Eckstein's team asked parents if their kids were "overweight" or "a little overweight." Few agreed, even if those descriptions were accurate.

Parents were better at picking sketches that looked like their child's body. The drawings showed kids of various shapes, ranging from very thin to several times larger.

In short, parents knew their kids' bodies. But they didn't always know when kids crossed the line from "normal" to "overweight."

"Sketches might be useful as a research tool," Eckstein tells WebMD.

About a quarter (26%) of those with overweight or nearly overweight kids voiced concern about their kids' weight, the researchers report.

Talking About It

Parents were more likely to recognize their child's weight problem and be concerned about it if a doctor had mentioned it, the study shows.

"I think that was actually an important and kind of encouraging finding, that if the physicians have indicated concerns, that that may heighten the parents' level of concern," Nancy Krebs, MD, MS, tells WebMD.

Krebs co-chairs the American Academy of Pediatrics' Task Force on Obesity. She's also a pediatrics professor at the University of Colorado's medical school.

Parents can ask doctors if their child's weight is keeping pace with growth. Waiting for a doctor to broach the topic isn't necessary.

In Eckstein's study, most parents of overweight or nearly overweight children said they didn't recall a doctor mentioning their child's weight problem. Those reports weren't confirmed.

Taboo Topic

When it comes to discussing kids' weights with parents, "so many docs don't want to go there," Krebs says. "They don't want to talk about this."

She sees several reasons for that reluctance. "One is that there's a perception that you can't do anything about it, and ... that parents don't want to change, they don't want to talk about it."

"It's considered a sensitive topic," Krebs continues. She adds that some doctors may get frustrated when they bring up the topic and then see no changes in their patients.

"These are huge issues. They're not easy," Krebs says, talking about behavior changes -- like eating more healthfully and boosting physical activity -- that can lead back to a normal weight.

Lagging Behind, Lingering 'Baby Fat'

Parents were more concerned about their kids' extra pounds if their kids were less active or slower than their peers, the study shows.

Evaluating kids' fitness could help flag the problem, Eckstein notes.

Ideally, parents would recognize weight problems before kids start lagging behind, Krebs says. "By the time they're to that point, it's already pretty far along," she explains.

Will kids outgrow their baby fat? Some people think so, and "some children do," says Eckstein.

But others stay heavy into adulthood. "Unfortunately, in our current environment, I don't think it's as high a likelihood as it used to be that they will outgrow it," says Krebs.

Being overweight is associated with health problems, some of which start in childhood, Krebs says. But not all overweight people have health problems, and slenderness doesn't guarantee health.

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