Journal of Child and Family Studies

, Volume 24, Issue 5, pp 1384–1391 | Cite as

Parental Perception of Child’s Body Weight: A Systematic Review

  • Connie L. Tompkins
  • Marissa Seablom
  • David W. Brock
Original Paper


If a parent does not accurately perceive their child’s overweight or obese status and potential health risk as a result of excess weight, they may be less inclined to encourage their child’s participation in healthy behaviors. This study systematically reviewed the past 5 years of literature regarding the accuracy of parental perception of their child’s weight status. PubMed, PsychInfo, and CINAHL databases from 2006 to 2012 were searched using key words related to parental perception and childhood overweight. Quantitative studies which assessed parental perception of their child’s body weight with height and weight measurements of the child (2–18 years of age) within the United States were included. Studies were excluded if the family was preparing to or currently receiving any kind of treatment or intervention for weight loss/management. Eligible articles which assessed and reported parental perception of their child’s body weight. Thirteen studies met the criteria for inclusion. Underestimation of obesity ranged from 13.3 to 100 % of parents of children with a BMI ≥95th percentile. In six of the studies, >70 % of parents of overweight children (≥85–<95th BMI percentile) underestimated their child’s weight status. Factors that affected accuracy of parental perception included word versus image classification, the child’s sex and age, ethnicity, and parental health literacy. To fully engage children who may be at risk for weight-related diseases in programs targeting physical inactivity and childhood obesity, efforts to improve accuracy of parental perception of their child’s weight are greatly needed.


Weight perception Body weight Childhood obesity Parental perception Child weight 


  1. Akerman, A., Williams, M. E., & Meunier, J. (2007). Perception versus reality: An exploration of children’s measured body mass in relation to caregivers’ estimates. Journal of Health Psychology, 12(6), 871–882. doi: 10.1177/1359105307082449.CrossRefPubMedGoogle Scholar
  2. Association, A. D. (2000). Type 2 diabetes in children and adolescents. Pediatrics, 105(3), 671–680.CrossRefGoogle Scholar
  3. Bayles, B. (2010). Perceptions of childhood obesity on the Texas-Mexico border. Public Health Nursing, 27(4), 320–328.CrossRefPubMedGoogle Scholar
  4. Birch, L. L., & Davison, K. K. (2001). Family environmental factors influencing the developing behavioral controls of food intake and childhood overweight. Pediatric Clinics of North America, 48(4), 893–907.CrossRefPubMedGoogle Scholar
  5. Brann, L. S. (2011). Parents’ and boys’ perceptions of boys’ body size for average and high BMI boys. Maternal & Child Nutrition, 7(3), 307–314. doi: 10.1111/j.1740-8709.2010.00242.x.CrossRefGoogle Scholar
  6. Dalton, W. T, 3rd, & Kitzmann, K. M. (2008). Broadening parental involvement in family-based interventions for pediatric overweight: Implications from family systems and child health. Family & Community Health, 31(4), 259–268. doi: 10.1097/01.FCH.0000336089.37280.f8.CrossRefGoogle Scholar
  7. De La O, A., Jordan, K. C., Ortiz, K., Moyer-Mileur, L. J., Stoddard, G., Friedrichs, M., et al. (2009). Do parents accurately perceive their child’s weight status? Journal of Pediatric Health Care, 23(4), 216–221. doi: 10.1016/j.pedhc.2007.12.014.CrossRefGoogle Scholar
  8. Eckstein, K. C., Mikhail, L. M., Ariza, A. J., Thomson, J. S., Millard, S. C., & Binns, H. J. (2006). Parents’ perceptions of their child’s weight and health. Pediatrics, 117(3), 681–690.CrossRefPubMedGoogle Scholar
  9. Freedman, D. S., Khan, L. K., Dietz, W. H., Srinivasan, S. R., & Berenson, G. S. (2001). Relationship of childhood obesity to coronary heart disease risk factors in adulthood: The Bogalusa Heart Study. Pediatrics, 108(3), 712–718.CrossRefPubMedGoogle Scholar
  10. Garrett-Wright, D. (2011). Parental perception of preschool child body weight. Journal of Pediatric Nursing, 26(5), 435–445.CrossRefPubMedGoogle Scholar
  11. Golan, M., Weizman, A., Apter, A., & Fainaru, M. (1998). Parents as the exclusive agents of change in the treatment of childhood obesity. American Journal of Clinical Nutrition, 67(6), 1130–1135.PubMedGoogle Scholar
  12. Guo, S. S., & Chumlea, W. C. (1999). Tracking of body mass index in children in relation to overweight in adulthood. American Journal of Clinical Nutrition, 70(1), 145S–148S.Google Scholar
  13. Hearst, M. O., Sherwood, N. E., Klein, E. G., Pasch, K. E., & Lytle, L. A. (2011). Parental perceptions of their adolescent’s weight status: The ECHO study. American Journal of Health Behavior, 35(2), 248–255.CrossRefPubMedCentralPubMedGoogle Scholar
  14. Hernandez, R. G., Cheng, T. L., & Serwint, J. R. (2010). Parents’ healthy weight perceptions and preferences regarding obesity counseling in preschoolers: Pediatricians matter. Clinical Pediatrics, 49(8), 790–798.CrossRefPubMedGoogle Scholar
  15. Huang, J. S., Becerra, K., Oda, T., Walker, E., Xu, R., Donohue, M., et al. (2007). Parental ability to discriminate the weight status of children: Results of a survey. Pediatrics, 120(1), e112–e119.CrossRefPubMedGoogle Scholar
  16. Hudson, C. E., Cherry, D. J., Ratcliffe, S. J., & McClellan, L. C. (2009). Head Start children’s lifestyle behaviors, parental perceptions of weight, and body mass index. Journal of Pediatric Nursing, 24(4), 292–301. doi: 10.1016/j.pedn.2008.04.006.Google Scholar
  17. National Football League. (2007). NFL Play 60, The NFL movement for an active generation. Retrieved October 11, 2013 from
  18. Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. British Medical Journal, 339, b2535. doi: 10.1136/bmj.b2535.CrossRefPubMedCentralPubMedGoogle Scholar
  19. National Heart, Lung, and Blood Institute. (2007). We Can! Ways to enhance children’s activity & nutrition. Retrieved October 11, 2013 from
  20. Let’s Move! (2010). America’s move to raise a healthier generation. Retrieved October 11, 2013 from
  21. Ogden, C. L., Carroll, M. D., Curtin, L. R., Lamb, M. M., & Flegal, K. M. (2010). Prevalence of high body mass index in US children and adolescents, 2007–2008. Journal of the American Medical Association, 303(3), 242–249. doi: 10.1001/jama.2009.2012.CrossRefPubMedGoogle Scholar
  22. Ogden, C. L., & Flegal, K. M. (2010). Changes in terminology for childhood overweight and obesity. National Health Statistics Report, 25, 1–5.Google Scholar
  23. Parry, L. L., Netuveli, G., Parry, J., & Saxena, S. (2008). A systematic review of parental perception of overweight status in children. Journal of Ambulatory Care Management, 31(3), 253–268.CrossRefPubMedGoogle Scholar
  24. Perrin, E. M., Jacobson Vann, J. C., Benjamin, J. T., Skinner, A. C., Wegner, S., & Ammerman, A. S. (2010). Use of a pediatrician toolkit to address parental perception of children’s weight status, nutrition, and activity behaviors. Academic Pediatrics, 10(4), 274–281. doi: 10.1016/j.acap.2010.03.006.CrossRefPubMedCentralPubMedGoogle Scholar
  25. Rhee, K. E., De Lago, C. W., Arscott-Mills, T., Mehta, S. D., & Davis, R. K. (2005). Factors associated with parental readiness to make changes for overweight children. Pediatrics, 116(1), e94–101. doi: 10.1542/peds.2004-2479.CrossRefPubMedGoogle Scholar
  26. Rosas, L. G., Harley, K. G., Guendelman, S., Fernald, L. C., Mejia, F., & Eskenazi, B. (2010). Maternal perception of child weight among Mexicans in California and Mexico. Maternal and Child Health Journal, 14(6), 886–894. doi: 10.1007/s10995-009-0534-6.CrossRefPubMedCentralPubMedGoogle Scholar
  27. Sallis, J. F., Prochaska, J. J., & Taylor, W. C. (2000). A review of correlates of physical activity of children and adolescents. Medicine and Science in Sports and Exercise, 32(5), 963–975.CrossRefPubMedGoogle Scholar
  28. Trost, S. G., Sallis, J. F., Pate, R. R., Freedson, P. S., Taylor, W. C., & Dowda, M. (2003). Evaluating a model of parental influence on youth physical activity. American Journal of Preventive Medicine, 25(4), 277–282.CrossRefPubMedGoogle Scholar
  29. Tschamler, J. M., Conn, K. M., Cook, S. R., & Halterman, J. S. (2010). Underestimation of children’s weight status: Views of parents in an urban community. Clinical Pediatrics, 49(5), 470–476.CrossRefPubMedGoogle Scholar
  30. Wald, E. R., Ewing, L. J., Cluss, P., Goldstrohm, S., Cipriani, L., Colborn, D. K., et al. (2007). Parental perception of children’s weight in a paediatric primary care setting. Child: Care, Health and Development, 33(6), 738–743.Google Scholar
  31. Young, P. C., DeBry, S., Jackson, W. D., Metos, J., Joy, E., Templeman, M., et al. (2010). Improving the prevention, early recognition, and treatment of pediatric obesity by primary care physicians. Clinical Pediatrics, 49(10), 964–969. doi: 10.1177/0009922810370056.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Connie L. Tompkins
    • 1
  • Marissa Seablom
    • 1
  • David W. Brock
    • 1
  1. 1.Department of Rehabilitation and Movement ScienceUniversity of VermontBurlingtonUSA

Personalised recommendations