Introduction: Recommendations from many health care organizations encourage the use of body mass index (BMI) to screen for overweight and obesity in children, including the Centers for Disease Control and Prevention, American Academy of Pediatrics, and the US Preventive Services Task Force.
Methods: Researchers examined data from almost 5,000 children aged 2 to 15 years who were overweight (ie, BMI ≥ 85th percentile). These data were collected as part of the National Health and Nutrition Examination Survey between 1999 and 2008. The children’s parents were asked to respond “yes” or “no” to the question, “Has a doctor or health professional ever told you that your child is overweight?”
Results: Only 22% of parents of overweight children recalled being told by a physician or other health professional of their child’s weight status. This percentage increased over time from a low of 19.4% in 1999 to a high of 29.1% in 2007-2008. The recall rates also increased with greater BMI but were still relatively low—58%—among parents of children with the highest BMI (≥99th percentile). In addition, the recall rate was higher among minorities, older children, and children from families with a lower income level.
Conclusion: Approximately two-thirds of parents of overweight children did not recall being counseled about their child’s weight.
Commentary by Louis Kuritzky MD
While scrutinizing many years of literature on smoking cessation efforts, I have been consistently surprised by the man-on-the-street surveys that query smokers about the advice they have received. Two separate surveys, one in the 1990s1 and one in the 2000s, reported that almost half of smokers said that no health professional had ever advised them to stop smoking! What does that really mean? Perusal of the study by Perrin et al on parental recall of doctor communication about weight status may give us some insight.2
For more than 2 decades it has been recommended that pediatricians provide information to parents about helping children attain and maintain a healthy weight. The US Preventive Services Task Force recently advocated screening for overweight/obesity beginning at age 6 years.
In this study by Perrin et al, there was some evidence of greater initiative regarding weight counseling over time, with 19.4% to 23.2% of parents of overweight/obese offspring recalling weight discussions in the 1999-2006 interval compared with 29.1% in the 2007 to 2008 interval. Distressingly, the number of adults informed by professionals about being overweight may actually be declining.3
Just as my “dubiometer” oscillates when I hear that the majority of smokers disclaim being informed about the need to stop smoking, I am similarly skeptical about parents of overweight/obese children lacking advice about weight management. In any case, such clinical trial data indicate we must redouble our efforts to make certain that overweight individuals throughout their lifespan become well informed of their status, the toxicities of excess weight, and steps for remedy.