Low-income Mothers Unconcerned About Children's Overweight

Mothers with low income levels are, in general, unconcerned about their children’s overweight as a health issue. These mothers also tend to define their children’s overweight more by behavior than by objective measurement.

Researchers from the University of Chicago Department of Pediatrics and the University of Cincinnati College of Medicine based these conclusions on the results of focus groups with 18 low-income mothers of preschool children at risk for later obesity. Fourteen of the 18 children enrolled at a clinic of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) were overweight, and another three were at risk for overweight, according to Centers for Disease Control and Prevention (CDC) definitions. Although researchers did not base participant selection on the mothers’ weight, twelve mothers were obese (BMI ¼ 30) and four were overweight (BMI ¼ 25).

Focus groups explored how the women determine when a child is overweight, why they think children become overweight, and what they can do to prevent or manage overweight in their children. Mothers do not rely on measurement or standardized growth charts to determine a healthy weight, the study found. Instead, they believe that as long as children are active, happy, and have good appetites, they are healthy. The mothers worried about children’s weight only if they were inactive, “lazy,” or teased about their weight.
The participants tended to speak about a child’s size in terms of bone structure, frame, and clothing size, and used terms like “big-boned,” “solid,” and “strong” to describe their children. Among the mothers of overweight children, only two were concerned about their child’s present weight and only five were concerned about their child’s weight in the future.

The women identified “nature” or heredity as the major determining factor of a child’s weight. They also believed that parents’ behaviors and the family environment affect children’s diet and activity patterns. The mothers found that controlling their child’s diet was difficult because of the influence of other family members; however, they themselves often used food to shape their children’s behavior, such as offering treats for good behavior. The mothers also had difficulty denying food to a child who claimed to be hungry, even if the child had just eaten.

Overweight in children is defined as body mass index (BMI) ¼ the 95th percentile for age and gender. Children at risk for overweight have a BMI ¼ the 85th percentile.

2000 CDC U.S. Pediatric Growth Charts

Although the study sample size was small, the focus group results suggest that health professionals and low-income mothers view the definition and causes of overweight differently. Both groups, however, agree that children should be physically active and follow healthy eating patterns. The authors propose that using growth charts when counseling low-income mothers of overweight children may not be useful. Focusing instead on shared goals may have a greater effect on preventing childhood obesity in this population.

This study, funded by the U.S. Department of Agriculture (USDA), Food and Nutrition Service, is reported in the May 5, 2001 issues of Pediatrics. s