Parental estimates of children’s weight status: evidence from Serbian children aged 6–9 years

Numerous studies have found that parents underestimate the overweight and obese weight status of their children, which may lead to future health risks. The purpose of the paper was to examine how parents in Serbia perceive their children's weight status. A nationally representative sample of 6-9-year-old children (n = 2700) was evaluated as part of the World Health Organization's (WHO) European Childhood Obesity Surveillance Initiative (COSI). The children's body mass index (BMI) was categorized as BMI-for-age Z-scores based on the 2007 WHO-recommended growth references. The family questionnaires, which were filled in by parents or caregivers, contained, among others, questions seeking to identify the adults' perceptions of their children's weight status. The weight distribution of the participant children was the following: 2% of the children were in the category of 'thinness', 20.6% were in 'overweight' and 14,7% were in the category 'obese'. A total of 83.2% of the parents accurately perceived their child's healthy weight (normal weight), however, 71% of the parents underestimated the overweight status of their children and 91,2% of the parents failed to acknowledge the obese status of their child according to the WHO definition. Childhood obesity should be continuously monitored; existing health promotion interventions should be more strictly controlled. This study found that parents need more health-related education in the future, with close cooperation of schools and stakeholders in raising healthier generations.