Parents' Healthy Weight Perceptions and Preferences Regarding Obesity Counseling in Preschoolers: Pediatricians Matter

Objective: To compare parental report of child body image with perceived healthy weight body image in preschoolers and describe weight-counseling preferences. Methods: Parents seeking well-child care were interviewed and asked to select images resembling: (a) their own child's current weight, (b) a healthy weight preschooler, and (c) friend and family report of a healthy weight preschooler. Those indicating that their overweight or obese child resembled a healthy weight image were considered to misclassify child weight. Logistic regression was used to identify predictors of misclassification and card-sorting exercises explored weight-counseling preferences. Results: Of the 150 preschoolers in our sample, 32.7% (n = 49) were overweight or obese with misclassification occurring in 71.4% of parents (n = 35). Absence of pediatrician comment on child weight strongly predicted misclassification (odds ratio, 12.3; 95% confidence interval, 1.74-87.2). Pediatricians were highly valued weight advisors. Conclusions: Weight-focused advice from pediatricians matters to parents and may promote parental identification of early childhood weight risks.