Introduction: Parents can act as important agents of change
and support for healthy childhood growth and development. Studies have found that parents may not be able to
accurately perceive their child’s weight status. The purpose
of this study was to measure parental perceptions of their
child’s weight status and to identify predictors of potential
parental misperceptions. Methods: We used data from the
World Health Organization (WHO) European Childhood
Obesity Surveillance Initiative and 22 countries. Parents
were asked to identify their perceptions of their children’s
weight status as “underweight,” “normal weight,” “a little
overweight,” or “extremely overweight.” We categorized
children’s (6–9 years; n = 124,296) body mass index (BMI) as
BMI-for-age Z-scores based on the 2007 WHO-recommended growth references. For each country included in the analysis and pooled estimates (country level), we calculated the
distribution of children according to the WHO weight status
classification, distribution by parental perception of child’s
weight status, percentages of accurate, overestimating, or
underestimating perceptions, misclassification levels, and
predictors of parental misperceptions using a multilevel logistic regression analysis that included only children with
overweight (including obesity). Statistical analyses were performed using Stata version 15 1. Results: Overall, 64.1% of
parents categorized their child’s weight status accurately
relative to the WHO growth charts. However, parents were
more likely to underestimate their child’s weight if the child
had overweight (82.3%) or obesity (93.8%). Parents were
more likely to underestimate their child’s weight if the child
was male (adjusted OR [adjOR]: 1.41; 95% confidence intervals [CI]: 1.28–1.55); the parent had a lower educational level
(adjOR: 1.41; 95% CI: 1.26–1.57); the father was asked rather
than the mother (adjOR: 1.14; 95% CI: 0.98–1.33); and the
family lived in a rural area (adjOR: 1.10; 95% CI: 0.99–1.24).
Overall, parents’ BMI was not strongly associated with the
underestimation of children’s weight status, but there was a
stronger association in some countries. Discussion/Conclusion: Our study supplements the current literature on factors
that influence parental perceptions of their child’s weight
status. Public health interventions aimed at promoting
healthy childhood growth and development should consider parents’ knowledge and perceptions, as well as the sociocultural contexts in which children and families live.The authors gratefully acknowledge support from a grant from
the Russian Government in the context of the WHO European Office for the Prevention and Control of NCDs. Data collection in the
countries was made possible through funding by: Albania: World
Health Organization through the Joint Programme on Children,
Food Security and Nutrition “Reducing Malnutrition in Children,” funded by the Millennium Development Goals Achievement Fund, and the Institute of Public Health; Bulgaria: Ministry
of Health, National Center of Public Health and Analyses, World
Health Organization Regional Office for Europe; Croatia: Ministry of Health, Croatian Institute of Public Health and World
Health Organization Regional Office for Europe; Czechia: Grants
AZV MZČR 17-31670 A and MZČR – RVO EÚ 00023761; Denmark: Danish Ministry of Health; France: French Public Health
Agency; Georgia: World Health Organization; Ireland: Health
Service Executive; Italy: Ministry of Health; Istituto Superiore di
sanità (National Institute of Health); Kazakhstan: Ministry of Health of the Republic of Kazakhstan and World Health Organization Country Office; Latvia: n/a; Lithuania: Science Foundation of
Lithuanian University of Health Sciences and Lithuanian Science
Council and World Health Organization; Malta: Ministry of
Health; Montenegro: World Health Organization and Institute of
Public Health of Montenegro; Poland: National Health Programme, Ministry of Health; Portugal: Ministry of Health Institutions, the National Institute of Health, Directorate General of
Health, Regional Health Directorates and the kind technical support of Center for Studies and Research on Social Dynamics and
Health (CEIDSS); Romania: Ministry of Health; Russia (Moscow): n/a; San Marino: Health Ministry; Educational Ministry; Social Security Institute; the Health Authority; Spain: Spanish Agency for Food Safety and Nutrition (AESAN); Tajikistan: World
Health Organization Country Office in Tajikistan and Ministry of
Health and Social Protection; and Turkmenistan: World Health
Organization Country Office in Turkmenistan and Ministry of
Health. The authors alone are responsible for the views expressed
in this article and they do not necessarily represent the views, decisions, or policies of the institutions with which they are affiliated.info:eu-repo/semantics/publishedVersio