Maternal concern and perceptions of overweight in Australian preschool-aged children

Objective: To assess maternal concern about overweight in Australian preschool-aged children and factors predicting maternal concern about children's current and future weight status. Design: Cross-sectional survey of child's body mass index and parent questionnaire. Setting: Metropolitan Melbourne, Victoria, 2002. Participants: A community-based cohort of 324 4-year-old children and their parents. Main outcome measures: Mothers' reports of concern about the child's current and future weight status, and perceptions of the child's weight, diet and activity relative to their peers were compared with the child's measured weight status, and parent and child characteristics. Results: The prevalence of overweight orobesity was 19%, but only 5% of mothers indicated concern about their child being currently overweight, while 16% worried their child would become overweight. Over 70% of mothers of overweight children saw them as being of similar weight to their peers. Most mothers saw their children as being equally or more active than other children and having a diet at least as healthy as their peers. Overweight daughters were more likely to elicit maternal concern about current weight than overweight sons (relative risk, 4.6; 95% CI, 1.1-19.8). Mothers were more likely to worry about their child's potential for future overweight if they or the child's father were overweight. Conclusions: Despite mounting public concern about childhood obesity in Australia, most mothers surveyed were not concerned about their child's weight, and many mothers did not perceive their overweight children as different from their peers. This may have implications for interventions that rely on acknowledgement of child overweight as a first step to change.