Parental perceptions on their child's weight status in North Macedonia

Abstract

Introduction: Obesity is a growing crisis, with onset in early childhood. Therefore, understanding the complexity of the family interplay is an important step. Aim: The purpose of this study was to explore parental perceptions of their child’s weight among a nationally representative sample of children living in North Macedonia. Materials and Methods: From October to December 2022, a cross-sectional study was conducted including children and their parents/caregivers who were living in North Macedonia. The study was a part of the 6thround of the WHO Childhood Obesity Surveillance Initiative (COSI). Parental perceptions were assessed through record forms and compared in relation to objectively measured weight status using anthropometric standardized procedures. WHO 2007 cut-off definitions on overweight/obesity were used. Wald χ2-tests were usedto explore relations between objectively measured weight status (i.e., body mass index -BMI) and parental perceptions of their child’s weight status. Statistical significance was set at p<0.05 a priori. Results: The sample was composed of 2613 school children with equal male to female representation and majority living in urban areas, whilst 31.8% of the children were living with overweight (including obesity). Parents underestimated their child’s weight status, especially regarding children with overweight and obesity. Conclusion: To the best of our knowledge, this is the first study in North Macedonia to explore parental perceptions of school children’s weight status and compare accuracy with objective measured children’s weight status. Our study further compliments previous evidence of parental underestimation of children living with overweight and obesity, which is a crucial factor in understanding and addressing childhood obesity