Maternal Misconceptions of Weight Status among Nepean Adolescents Vanessa A. Shrewsbury, PhD; Sarah P. Garnett, PhD; Karen Campbell, PhD; Alison Carver, PhD; Siranda Torvaldsen, PhD; Katharine S. Steinbeck, PhD, FRACP; Chris T. Cowell, MB, FRACP; Louise A. Baur, PhD, FRACP A DOLESCENT OVERWEIGHT/OBESITY IS A MAJOR public health concern due to its high prevalence 1,2 and substantial health impacts. 3 Early recognition and management of overweight is fundamental to arresting further weight gain. However, intervention is un- likely to occur if parents dismiss their child’s adiposity or con- sider it a transitory stage. Systematic reviews of studies on the accuracy of parental perceptions of their child’s weight indi- cate that the majority of parents fail to recognize over- weight. 4,5 The findings are consistent for both adolescent and pre-adolescent children, although most of the reviewed stud- ies focused on pre-adolescents. 4,5 Other studies 6-8 have grouped adolescents with younger children, making it impos- sible to specifically examine parental perceptions according to age. Parental concern about their adolescent’s weight sta- tus also influences adolescent’s weight-related behaviors 9,10 and therefore is important to consider in adolescent over- weight prevention/management. Previous studies of parental concern 9,10 and percep- tions 11-13 about their adolescent’s weight have been cross- sectional. Some of these studies also examined various pre- dictors of maternal misclassification of adolescent weight status, including maternal education, maternal weight status, and adolescent weight-management practices. 11-13 Adoles- cence is a dynamic developmental stage characterized by rapid physical growth and puberty. Such changes may alter parental beliefs about their adolescent’s weight. The novel aspect of this study is the analysis of longitudinal data to ex- amine the changes in parental perceptions and concerns about their child’s weight status through adolescence. This is the first study to investigate adolescents’ weight in mid-child- hood and timing of puberty as predictors of parental misclas- sification of adolescent overweight. The findings will inform strategies to improve parental awareness about adolescent overweight. This study aimed to examine the changes between early and mid-adolescence in: (a) the accuracy of parental percep- tion regarding their adolescent’s weight status, (b) the degree of parental concern about their adolescent’s weight status, and (c) the predictors of parental misclassification of adoles- cent overweight as average weight. We hypothesize that (a) parents will be unable to recognize adolescent overweight, ABSTRACT Adolescence is characterized by rapid physical growth and sexual maturation. These changes may alter parents’ beliefs about their adolescent’s weight status. This study aimed to examine the changes between early and mid-adolescence in: (a) the accuracy of maternal perception regarding her adolescent’s weight status, (b) the degree of ma- ternal concern about her adolescent’s weight status, and (c) the predictors of maternal misclassification of adolescent overweight as average weight. A secondary analysis of the longitudinal Nepean Study data was conducted. Participants were Australian, free- living 13-year-olds in 2002-2003 (n=347) followed up at age 15 years (n=279) and their mothers. Participants’ body mass index (BMI) status (overweight, normal, or under- weight) was calculated from measured height and weight. Maternal perceptions and concerns about adolescent’s weight status were determined by items adapted from the Child Feeding Questionnaire. Sex-adjusted binary logistic regression models assessed potential predictors of maternal misclassification of adolescent overweight. Data were available on 224 adolescent-mother dyads. Approximately one fourth of mothers mis- classified their adolescent’s weight status, but this varied across groups (age 13 years [%]; age 15 years [%], respectively) underweight (75%; 70%), overweight (54%; 59%), and normal weight (12%; 9%). The endpoint data show that between 13 and 15 years of age, maternal concern regarding their adolescent’s weight decreased in all weight-status groups. Predictors of maternal misclassification of adolescent overweight were adoles- cent BMI z score, recent weight-management practices, weight history, sex, and mater- nal concern regarding her adolescent’s weight. These results reinforce the need for strategies in primary care that are implemented throughout adolescence to improve maternal awareness of childhood overweight. J Acad Nutr Diet. 2012;112:2007-2013. ARTICLE INFORMATION Article history: Accepted 17 August 2012 Keywords: Adolescent Obesity Maternal perceptions Longitudinal study Copyright © 2012 by the Academy of Nutrition and Dietetics. 2212-2672/$36.00 doi: 10.1016/j.jand.2012.08.024 RESEARCH Research and Professional Briefs © 2012 by the Academy of Nutrition and Dietetics. JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS 2007