Child/Adolescent Health

Overweight adolescents with type 2 diabetes underestimate their weight problem, as do their parents

Over 80 percent of children with type 2 diabetes are overweight or at risk for becoming overweight. These excess pounds increase their risk of developing diabetes-related complications, such as eye or kidney disease. Yet, severely overweight adolescents (mean body mass index, BMI, of 36.4 kg/m2) and their parents tend to underestimate the seriousness of their weight problem, finds a new study.

This misperception is also linked to poorer diet and more perceived barriers to healthy exercise and diet behaviors, note the researchers. They interviewed 104 adolescents (ages 12 to 20) and their parents about perceptions of the adolescents' weight, diet, and exercise behaviors, as well as barriers to engaging in these behaviors. They also calculated the child's BMI based on weight documented in their clinical records.

While 87 percent of children were overweight (a mean of 221 pounds), only 41 percent of parents and 35 percent of adolescents considered the adolescent "very overweight." Also, 40 percent of parents and 55 percent of adolescents with BMIs at or above the 95th percentile considered their weight "about right."

Adolescents were more likely to underestimate their weight when their parents also underestimated their weight than when parents accurately perceived their weight (66.2 vs. 34.2 percent). Girls were more likely than boys to underestimate the severity of their weight problem (42.9 vs. 22 percent), but parental accuracy did not differ by the child's sex.

Both parents and adolescents who underestimated the adolescent's weight were less likely to report good dietary behaviors and physical activity (although more weakly correlated) and more likely to report barriers to healthy diet and exercise than those who correctly estimated or overestimated the adolescent's weight. The study was supported in part by the Agency for Healthcare Research and Quality (T32 HS00032).

More details are in "Accuracy of perceptions of overweight and relation to self-care behaviors among adolescents with type 2 diabetes and their parents," by Asheley Cockrell Skinner, Ph.D., Morris Weinberger, Ph.D., Shelagh Mulvaney, Ph.D., and others, in the February 2008 Diabetes Care 31(2), pp. 227-229.

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