Abstract P261: Overweight/Obese Mother-Child Dyads Underestimate Size - A Present and Future Problem for Cardiovascular Risk
Introduction: Perception of body size is a key influence driving health behavior. Mothers directly influence children’s nutritional and exercise behaviors. Mothers of ethnic minority groups and/or lower socioeconomic status are less likely to correctly identify young children as overweight or obese.
Hypothesis: Overweight/obese mothers and children are more likely to misperceive self and others.
Methods: To determine self-perception of weight status and identify the “ideal” adult woman body size, 200 mother-child dyads visiting an outpatient clinic of the Columbia University Medical Center were assessed. Anthropomorphic measures [height, weight, waist, body mass index (BMI)], attitudes towards weight, and lifestyle behavior were determined. Validated silhouette scales were utilized to assess current and “ideal” size of pairs.
Results: Mothers (n=200) and children (n=200), girls (51.5%; 103/200) and boys (48.5%; 97/200), were primarily Hispanic (80.0%; 160/200) and Medicaid recipients (76.4%; 152/199). Adult age was 39.3 ± 7.5 years, and children, 10.6 ± 1.4 years. Adult BMI was categorized as obese (BMI ≥ 30 kg/m2, 31%; 62/200); overweight (BMI 25.0 - 29.9 kg/m2, 39%; 78/200); and normal (BMI 18.5 - 24.9, 30%; 59/200). Child BMI was categorized as obese (>95% on standardized growth curve (SGC), 23.9%; 47/197); overweight (85-95% on SGC, 20.8%; 41/197); and normal (<85% on SGC, 54.8%; 108/197). Normal weight was the reference standard.
Most obese mothers (79.0%; 49/62) underestimated their size and self-identified as merely overweight or even normal weight (p<0.0001). Among obese women, 21.0% (13/62) thought an overweight or obese body size was “ideal” (p<0.0001). The majority of normal weight mothers (69.0%; 40/58) had normal weight children; among overweight/obese mothers, 51.1% (70/137) had an overweight or obese child (p =0.01). The majority of mothers of overweight children (82.5%; 33/40) underestimated child’s weight as normal (p<0.0001).
Normal weight children were more likely to choose smaller silhouettes compared to overweight/obese peers (p<0.0001). Most overweight (87.8%; 36/41) and obese children (68.1%; 32/47) underestimated self-size as well, identifying themselves as normal weight (p<0.0001). Among young children of obese mothers, only 12.9% (8/62) correctly identified their mother as obese (p<0.0001).
Conclusion: In summary, misperception of size has intergenerational associations. Overweight/obese mothers and children are less likely to identify their own or family members’ correct body size. Underestimation of self-size may extend to distorted perception of ideal size for others. Failure to recognize overweight/obese status raises concern that prolonged exposure to obesity-related co-morbidities among young children places them at increased risk of cardiovascular disease in adolescence and adulthood.
- © 2013 by American Heart Association, Inc.