Time to Get Real About Your Toddler's Weight

Research has shown that when kids as young as 2 years old are overweight or obese, they're at significantly higher risk of becoming obese adults. In other words, it's important for parents to pay attention and act early to ensure their kids remain at a healthy weight throughout their lifetime. Unfortunately, new research shows that parents of an overweight child aren't so good at recognizing that there's a weight problem. And they're even worse if their pediatrician hasn't provided any guidance in this area. Which, as it turns out, very few of them do, according to the new study.

THE DETAILS: In the study, conducted jointly by teams from the University of South Florida and Johns Hopkins University, researchers interviewed 150 parents of preschoolers aged 2 to 5 during well-child visits to a health clinic. During the interview, the parents were shown images of other children and asked to pick which one was the same weight as their own child.

Of the 150 preschoolers in the study sample, 49 (32.7 percent) of them were overweight or obese. Yet 35 (71.4 percent) of the parents of overweight or obese children classified their kid as having a healthy weight. Importantly, the researchers found that a strong predictor of this misclassification was when pediatricians had never commented on the child's weight during visits. That is, parents of an overweight child who hadn't been given a heads-up from their doc didn't notice the weight problem on their own.

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The phenomenon may explain a statistical conundrum. A national survey released last week found that 84 percent of parents believe their children are at a healthy weight, even though research shows that nearly one-third of U.S. children and teens are now overweight or obese.

WHAT IT MEANS: The old adage that you need to recognize a problem before being able to solve it applies here. Clearly, the parents in this study weren't recognizing when their child was overweight or obese, in part because their pediatrician hadn't mentioned it.

The question is, why hadn't they? "Telling parents that their preschooler is overweight or obese is a very tough job, though it is absolutely our duty to relay this information to parents," says lead author Raquel Hernandez, MD, MPH, assistant professor of pediatrics at the University of South Florida. "But often, even when we do give this message to parents, they are insulted or angered by the implication that they are doing something wrong." And both doctors and parents need more guidance for managing weight problems in very young children. "There are currently very few evidence-based guidelines on nutrition and obesity among preschoolers," says Dr. Hernandez. "Telling parents their kid needs 30 minutes of physical activity three times a week isn't developmentally appropriate for a 2-year-old." As a result, doctors may end up having to impart bad news without being able to share proven strategies for fixing the problem.

On top of that is a perception problem. "For many people, I think that a happy, pudgy toddler still carries the meaning that the parent is doing a good job with feeding, caring for, and loving the child," says Dr. Hernandez. That may have been the case as recently as 20 years ago. But calories are a lot easier to come buy in today's society, while exercise is less common. And with childhood obesity reaching epidemic proportions, a classroom of chubby children makes it harder for parents to realize what a healthy weight actually looks like.

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So what's a parent to do? Dr. Hernandez suggests the following:

Ask the doc.
"Absolutely, checking with your child's pediatrician is number one."

Beware of portion sizes.
"A good rule of thumb is, if you feel like the child is eating as much as you are, there's a good chance your child could be overweight or obese," she says. Portion sizes are tough for parents to gauge. Often, children overeat simply because they're served as much food as the adults.

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Monitor your child's energy balance.
Obesity is not just about food. "Think about how much time your child spends being active (running, swimming, playing outdoors) versus how much time he or she spends watching TV, on the computer, or just being sedentary." The good news: New research shows that parents who set limits for TVand other screen time will, in fact, reduce their child's time spent in front of the screen—as long as the parents enforce the limits consistently.

Be the smartest parent on the block — and keep your family lean and fit for life!