P0209 - Parental Perception of Child’s Weight Versus Reality in Children Between 0 – 12 Years of Age. A BMI Percentile Approach.

Purpose
To determine if there is a discrepancy between the parent's perception of their child's BMI(pBMI) and their child's real BMI(rBMI).
Obesity is emerging as one of the most severe health concerns among children and adolescents. Some studies have demonstrated that physical activity alone does not statistically decrease an obese child's BMI; but interventions involving parents have proven success in sustained weight loss. Additionally, parental perception of their child’s BMI has not been well studied. We think that parents of overweight children believe their kids have a healthy weight and don't properly conceive their real BMI.

Methods
We did a cross-sectional study and categorized participants into two groups: healthy weight (BMI<85th) and overweight (BMI≥85th). Instead of BMI, weight for length was used for children below the age of two. For pBMI, parents were asked to score their child on a scale 0-10. We transformed the rBMI to a 10-point scale to compare it to pBMI. We used the Centers for Disease Control and Prevention (CDC) BMI guidelines to define overweight.
Surveys were conducted from December 2019-February 2020 at University Health System clinic in San Antonio before a primary care well-child visit. 94 surveys completed, and two excluded. Questionnaires were exclusively filled by the parents.
Data Collected: Demographics, BMI perception, lifestyle habits, and willingness to attend an education session.
Inclusion criteria: Children between 0-12 years. Exclusion: children with a history of prematurity and chronic/complex medical conditions.

Results
Ninety-two patients were included in analyses. Forty(43%) patients were overweight. Fifty-three(57%) parents denied their physicians having discussed BMI during previous visits. Of those, 25(27%) were overweight. The healthy group pBMI median score was 5(IQR 3) and rBMI 5(IQR 4.5) p0.89. In the overweight group, the pBMI median score was 6(IQR 1) and rBMI 9.5(IQR 0.75) p<0.000. Furthermore, those where physicians had discussed their child's BMI the pBMI vs. rBMI scores were 5.5(IQR 2) vs. 9.1(IQR 0.75)p<0.000, and those that had not, the scores were 6(IQR 1) vs. 9.6(IQR 0.8) p<0.000 respectively. When we compared the discrepancy between pBMI vs. rBMI, the mean discrepancy for the healthy group was 0.063(SD±3.3) and the mean discrepancy for the overweight group was 3.7(SD±1.2) with a p0.0001.

Conclusions
Parents of overweight children underestimate their child's BMI, and 87% of these parents believe their child's weight to be healthy. Just 32% of the parents of overweight children are willing to attend an education session. It is plausible to conclude that if the parents believe their child has a healthy weight, then they do not feel compelled to intervene.
Parents of healthy-weight children pBMI were similar to the real one, perhaps suggesting that being aware of one's child’s weight status could play a significant role in leading a healthy lifestyle.