Weight Status: When Ignorance May Not Be Bliss

By Deborah Cho

A recent data brief summarizing a national survey spanning from 2005-2012 on the perception of weight status in U.S. children and adolescents highlights one major finding — many children and adolescents who are overweight or obese don’t know it.  Key findings were that about 81% of overweight (defined as having age- and sex-specific BMI greater than or equal to the 85th and less than the 95th percentile of the 2000 CDC growth chart) boys and 71% of overweight girls believe they are about the right weight.  Additionally, nearly 48% of obese (defined as having age- and sex-specific BMI greater than or equal to the 95th percentile of the 2000 CDC growth chart) boys and 36% of obese girls consider themselves to be about the right weight.  

As an article on the NPR blog noted, “Kids can be cruel, especially about weight. So you might think overweight or obese children know all too well that they’re heavy.”  But it seems that this is not the case, at least according to the survey.  Furthermore, not only do overweight or obese children generally seem to be unaware of their weight status, but the misperception rate appears to be higher in those children and adolescents whose families have a lower income-to-poverty ratio.  Non-Hispanic black and Mexican American children and adolescents were also found to have higher rates of misperception than Non-Hispanic white children and adolescents.

Though children and adolescents being teased about weight is not something to be desired, the NPR blog post cites to a study finding that recognizing one’s weight status can increase the likelihood of behavioral changes that can help fight obesity.  This finding, which seems to be supported by common sense, highlights the physical harm that misperception about weight status can have on individuals.  It follows that these children and adolescents should (or must) be accurately informed of their weight status and the need to implement changes in their lives, but how, practically, can that be done?

One possible answer is that parents should be responsible for educating their children and encouraging a healthy lifestyle, but increasing rates of obesity might imply that additional interventions may be necessary.  However, adults outside the home, such as teachers or health care providers, bluntly informing children and adolescents that they are overweight or obese and need to make lifestyle changes will probably leave a bad taste in many mouths.  Concerns to this approach may include the fear that children will develop a low self-esteem that is not worth the chance at an increased likelihood of a healthier lifestyle or might also include other more serious issues associated with bullying.  These concerns will only be exacerbated by the fact that the misperception could be worse in populations that may have less access to healthy foods and the ability to exercise safely.  Lastly, simply providing a scale and access to publicly available information on healthy weights is clearly not enough to inform young people (or perhaps adults also) that they are overweight or obese.

So, the question is: What do we do now?

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