Parent and health care provider views on use of the terms overweight and obese to describe children

Background: recent Expert Committee guidelines for the prevention and treatment of childhood obesity recommend using the terms overweight and obesity for record keeping and risk assessment but not for interactions with families to “avoid an inference of judgment or repugnance.” This raises questions such as: how parents will learn about their child's weight status, how public health warnings about obesity risks can be effective in a “don't tell” environment, and whether a parent's right to know their child's weight status conflicts with the right for respectful treatment.

Methods: we conducted interviews with a statewide, stratified sample of parents and surveys with a statewide sample of health care providers in conjunction with a multi-method, multi-informant evaluation of WV's childhood obesity legislation funded by the Robert Wood Johnson Foundation.

Results: we obtained 1500 interviews and 124 surveys, respectively, from parents and providers. Results revealed only 26% of parents reported that providers discussed children's weights in the past 2 years; among those parents, 12% were told the child was overweight and < 1% were told the child was obese; 99% of parents want to be told if their child is overweight or obese; < 5% of parents would be “very offended” if told their child was obese; 99% of providers believe that parents should be told if their children are obese, and 33% of providers rarely or never calculate BMI percentiles for children.

Discussion: the significance of these findings and implications for public health messages and provider interactions are discussed.