Skip to main content
SpringerLink
Log in

Is My Kid Out of Size? Indian Mothers’ Desirability Bias in Evaluation of Their Children’s Weight

  • ORIGINAL ARTICLE
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Objective

To quantify mothers’ social desirability bias with respect to their children’s weight in a cross-regional Indian setting.

Methods

The OBEY-AD was a cross-sectional study which has been realized in 7 Indian cities (Bengaluru, Mumbai, Chennai, Hyderabad, Kolkata, New Delhi and Surat), enroling 1,680 children aged 3–11 y of which 50 % were females. Children’s BMI scores were computed, standardized according to WHO growth charts and categorized as Normal, Overweight, Obese and Underweight. Mothers were asked to judge the weight status of their children through an iconographic test, indicating the shape, which better mirrors the size of their kids. Socio-demographic data, especially employment, income and education, was accessed by administrating a cross-sectional questionnaire to the mothers, involved for the study.

Results

Overall, 369 children resulted as obese or overweight (23.5 %). Out of them, 75 % (278) were not recognized as such by their mothers. Such figures range from up to 76 % in Chennai and Surat down to 72 % in Hyderabad, Kolkata, New Delhi and Mumbai. Overall agreement between perceived and desired weight status of children was very poor (p < 0.001). Surprisingly, overall 10 % of overweight/obese children were considered as even too lean by their mothers.

Misperception of children’s weight status seemed to be significantly related to urban differences and socio-economic status.

Conclusions

This study quantifies the extent of the so-called social desirability bias, namely mother’s unconscious attitude to adapt empirical evidence to more culturally legitimized ideal-types of what their children’s weight status is expected to be. Its association with westernized representations of leanness as evaluation criteria for beauty has important policy implications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Chkili W, Nguyen DK. Exchange rate movements and stock market returns in a regime-switching environment: evidence for BRICS countries. Res Int Bus Finance. 2014;31:46–56.

    Article  Google Scholar 

  2. Chandra PS, Abbas S, Palmer R. Are eating disorders a significant clinical issue in urban India? A survey among psychiatrists in Bangalore. Int J Eat Disord. 2012;45:443–6.

    Article  PubMed  Google Scholar 

  3. Mantovani G. Exploring borders. Understanding culture and psychology. London: Rootledge; 2000.

    Google Scholar 

  4. Singh RB, Beegom R, Mehta AS, Niaz MA, De AK, Mitra RK, et al. Social class, coronary risk factors and undernutrition, a double burden of diseases, in women during transition, in five Indian cities. Int J Cardiol. 1999;69:139–47.

    Article  PubMed  CAS  Google Scholar 

  5. Krishnan A, Shah B, Lal V, Shukla DK, Paul E, Kapoor SK. Prevalence of risk factors for non-communicable disease in a rural area of Faridabad district of Haryana. Indian J Public Health. 2008;52:117–24.

    PubMed  CAS  Google Scholar 

  6. Daniel CR, Prabhakaran D, Kapur K, Graubard BI, Devasenapathy N, Ramakrishnan L, et al. A cross-sectional investigation of regional patterns of diet and cardio-metabolic risk in India. Nutr J. 2011;10:12.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Bauman Z. Consuming Life. Cambridge: Polity Press; 2007.

    Google Scholar 

  8. Goffman E. Stigma: Notes on the management of spoiled identity. New York: Prentice Hall; 1963.

    Google Scholar 

  9. Faccio E. The corporeal identity: When the self-image hurts. New York: Springer; 2013.

    Book  Google Scholar 

  10. Vaisrub S. Beware the lean and hungry look. JAMA. 1980;243:1844.

    Article  PubMed  CAS  Google Scholar 

  11. Bourdieu P. Distinction: A social critique of the judgment of taste. Oxon: Routledge; 2010.

    Google Scholar 

  12. Rietmeijer-Mentink M, Paulis WD, van Middelkoop M, Bindels PJ, van der Wouden JC. Difference between parental perception and actual weight status of children: a systematic review. Matern Child Nutr. 2013;9:3–22.

    Article  PubMed  Google Scholar 

  13. Hook JL. Care in context: men's unpaid work in 20 centuries. Am Sociol Rev. 2006;71:639–60.

    Article  Google Scholar 

  14. APA. Diagnostic and statistical manual of mental disorders. 5th ed. Washington: American Psychiatric Association; 2013.

    Google Scholar 

  15. Sarkar S, Padhy SK, Rao P, Gupta S. Transient eating problems in an adolescent without body image disturbances: a diagnostic quandary. Indian J Psychol Med. 2013;35:410–2.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Pepe A, Armenti A. Knowledge building processes in blended learning communities: forum usage evaluation from a participatory framework for distance cooperation. Edulearn. Barcelona - Spain: IATED; 2009. p. 5075–85.

  17. Joshi SR, Mohan V, Joshi SS, Mechanick JI, Marchetti A. Transcultural diabetes nutrition therapy algorithm: the Asian Indian application. Curr Diab Rep. 2012;12:204–12.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Ramachandran A, Chamukuttan S, Shetty SA, Arun N, Susairaj P. Obesity in Asia–is it different from rest of the world. Diabetes Metab Res Rev. 2012;28 Suppl 2:47–51.

    Article  PubMed  Google Scholar 

  19. Jodelet D. Les représentations sociales dans le champ de la culture. Soc Sci Inf. 2002;41:111–33.

    Article  Google Scholar 

  20. Asch S. Studies on independence and conformity: I.A. minority of one against a unanimous majority. Psychol Monogr. 1956;70:1–70.

    Article  Google Scholar 

  21. Torres DD. Understanding how family socioeconomic status mediates the maternal intelligence-child cognitive outcomes relationship: a moderated mediation analysis. Biodem Soc Biol. 2013;59:157–77.

    Article  Google Scholar 

  22. Keogh P. Defining Intelligence in an educational context. Bloomington: Author House; 2011.

    Google Scholar 

  23. Abbott RA, Lee AJ, Stubbs CO, Davies PS. Accuracy of weight status perception in contemporary Australian children and adolescents. J Paediatr Child Health. 2010;46:343–8.

    Article  PubMed  Google Scholar 

  24. Al-Qaoud NM, Al-Shami E, Prakash P. Kuwaiti mothers' perception of their preschool children's weight status. J Dev Behav Pediatr. 2010;31:505–10.

    Article  PubMed  Google Scholar 

  25. Muhammad NA, Omar K, Shah SA, Muthupalaniappen LA, Arshad F. Parental perception of their children's weight status, and its association with their nutrition and obesity knowledge. Asia Pac J Clin Nutr. 2008;17:597–602.

    PubMed  Google Scholar 

  26. Maynard LM, Galuska DA, Blanck HM, Serdula MK. Maternal perceptions of weight status of children. Pediatrics. 2003;111:1226–31.

    PubMed  Google Scholar 

  27. Guendelman S, Fernald LC, Neufeld LM, Fuentes-Afflick E. Maternal perceptions of early childhood ideal body weight differ among Mexican-origin mothers residing in Mexico compared to California. J Am Diet Assoc. 2010;110:222–9.

    Article  PubMed  Google Scholar 

  28. Boa-Sorte N, Neri LA, Leite ME, Brito SM, Meirelles AR, Luduvice FB, et al. Maternal perceptions and self-perception of the nutritional status of children and adolescents from private schools. J Pediatr (Rio J). 2007;83:349–56.

    Google Scholar 

  29. Carnell S, Edwards C, Croker H, Boniface D, Wardle J. Parental perceptions of overweight in 3–5 y olds. Int J Obes (Lond). 2005;29:353–5.

    Article  CAS  Google Scholar 

  30. Lazzeri G, Casorelli A, Giallombardo D, Grasso A, Guidoni C, Menoni E, et al. Nutritional surveillance in Tuscany: maternal perception of nutritional status of 8–9 y-old school-children. J Prev Med Hyg. 2006;47:16–21.

    PubMed  CAS  Google Scholar 

  31. Gregori D, Gulati A, Hochdorn A, Ballali S, Paramesh H, Kumar M, et al. Food packaged with toys: an investigation on potential obesogenic effects in Indian children. Indian J Pediatric. 2014. doi:10.1007/s12098-014-1448-x.

  32. APA. Ethical principles of psychologists and code of conduct. Washington: American Psychological Association; 2002.

    Google Scholar 

  33. WHO. Growth reference data for 5–19 years. Geneva: World Health Organization; 2007.

  34. WHO. The WHO Multicentre Growth Reference Study (MGRS). Geneva: World Health Organization; 2003.

  35. IAP. IAP Growth Charts. Patna: Indian Academy of Pediatrics; 2014.

  36. Gwet KL. Computing inter-rater reliability and its variance in the presence of high agreement. Br J Math Stat Psychol. 2008;61:29–48.

    Article  PubMed  Google Scholar 

  37. WHO. Global health risk: mortality and burden of disease attribuatable to selected major risk. Geneva: World Health Organization; 2009.

  38. Aljunaibi A, Abdulle A, Nagelkerke N. Parental weight perceptions: a cause for concern in the prevention and management of childhood obesity in the United Arab Emirates. PLoS One. 2013;8:e59923.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  39. Skar M, Villumsen AB, Christensen DL, Petersen JH, Deepa M, Anjana RM, et al. Increased risk of type 2 diabetes with ascending social class in urban South Indians is explained by obesity: the Chennai urban rural epidemiology study (CURES-116). Indian J Endocr Metab. 2013;17:1084–9.

    Article  Google Scholar 

  40. Deepa M, Anjana RM, Manjula D, Narayan KM, Mohan V. Convergence of prevalence rates of diabetes and cardiometabolic risk factors in middle and low income groups in urban India: 10-year follow-up of the Chennai Urban Population Study. J Diabet Sci Technol. 2011;5:918–27.

    Article  Google Scholar 

  41. Ramachandran A, Mary S, Yamuna A, Murugesan N, Snehalatha C. High prevalence of diabetes and cardiovascular risk factors associated with urbanization in India. Diabetes Care. 2008;31:893–8.

    Article  PubMed  Google Scholar 

  42. Kapur D, Sharma S, Agarwal KN. Dietary intake and growth pattern of children 9–36 months of age in an urban slum in Delhi. Indian Pediatr. 2005;42:351–6.

    PubMed  Google Scholar 

  43. Chacko E. From brain drain to brain gain: reverse migration to Bangalore and Hyderabad, India's globalizing high tech cities. GeoJournal. 2007;68:131–40.

    Article  Google Scholar 

  44. Cook J, Chatterjee S, Sur D, Whittington D. Measuring risk aversion among the urban poor in Kolkata, India. Appl Econ Lett. 2013;20:1–9.

    Article  Google Scholar 

  45. Agarwal DK, Agarwal KN, Upadhyay SK, Mittal R, Prakash R, Rai S. Physical and sexual growth pattern of affluent Indian children from 5 to 18 years of age. Indian Pediatr. 1992;29:1203–82.

    PubMed  CAS  Google Scholar 

  46. Agarwal KN, Saxena A, Bansal AK, Agarwal DK. Physical growth assessment in adolescence. Indian Pediatr. 2001;38:1217–35.

    PubMed  CAS  Google Scholar 

  47. Khadilkar V, Khadilkar A. Growth charts: a diagnostic tool. Indian J Endocr Metab. 2011;15 Suppl 3:S166–71.

    Article  Google Scholar 

  48. Khadilkar VV, Khadilkar AV, Borade AB, Chiplonkar SA. Body mass index cut-offs for screening for childhood overweight and obesity in Indian children. Indian Pediatr. 2012;49:29–34.

    Article  PubMed  CAS  Google Scholar 

  49. Kumaravel V, Shriraam V, Anitharani M, Mahadevan S, Balamurugan AN, Sathiyasekaran B. Are the current Indian growth charts really representative? Analysis of anthropometric assessment of school children in a South Indian district. Indian J Endocrinol Metab. 2014;18:56–62.

  50. Griffiths PL, Bentley ME. The nutrition transition is underway in India. J Nutr. 2001;131:2692–700.

    PubMed  CAS  Google Scholar 

Download references

Contributions

AH, IB, AG and DG: Designed the study; AH, MK and ECP: Wrote the manuscript; IB and DG: Performed the statistical analysis. All authors contributed to results interpretation, read and approved the final manuscript. DG will act as guarantor for this paper.

Conflict of Interest

None.

Source of Funding

This work is partially supported by an unrestricted grant from the Italian Ministry of Foreign Affairs, Directorate General for Country Promotion, and from Prochild ONLUS (Italy).

Author information

Authors and Affiliations

  1. Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Via Loredan, 18, 35121, Padova, Italy

    Alexander Hochdorn, Ileana Baldi & Dario Gregori

  2. College of Nursing, Lakeside Institute of Child Health, Lakeside Hospital, Bangalore, India

    Elizabeth Cherian Paramesh

  3. Internal Research Unit, Kare Centre, Chennai, India

    Malathi Kumar

  4. Department of Otorhinolaryngology (ENT), Maulana Azad Medical College, New Delhi, India

    Achal Gulati

Authors
  1. Alexander Hochdorn
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ileana Baldi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Elizabeth Cherian Paramesh
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Malathi Kumar
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Achal Gulati
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Dario Gregori
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ileana Baldi.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hochdorn, A., Baldi, I., Paramesh, E.C. et al. Is My Kid Out of Size? Indian Mothers’ Desirability Bias in Evaluation of Their Children’s Weight. Indian J Pediatr 81 (Suppl 1), 39–46 (2014). https://doi.org/10.1007/s12098-014-1464-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12098-014-1464-x

Keywords

Search

Navigation