More than one in three children in the United States are obese or overweight, so pediatricians already have their work cut out for them. But there's now evidence that they may need to start treating parents for an acute case of denial.
A recent study exploring parents' involvement in treating childhood obesity found that even when faced with clear evidence, many parents aren't willing to admit that their child's weight problem might be a health issue.
The study, recently published in the Journal of the Academy of Nutrition and Dietetics, surveyed the parents of more than 200 children who had been admitted to an obesity clinic in Providence, R.I.
Again, these are parents whose pediatricians had already told them that they had an obese child -- and had agreed to admit that child to a program for obesity treatment.
Most of the parents surveyed acknowledged that their child was overweight or obese, but 31 percent of them perceived their child's health to be "excellent" or "very good" and 28 percent didn't perceive their child's weight to be a health problem.
So what's behind this denial?
"I do think a lot of times there's a disconnect with weight and health, which for children I think is probably legitimate because a lot of children are overweight without these metabolic or chronic health problems," said Kyung E. Rhee, an assistant professor of pediatrics at the University of California, San Diego, and the author's lead study.
But Rhee added that some of the children did have signs of potentially serious health problems like glucose intolerance or hypertension. And, she said, doctors don't always perform the tests that can diagnose those issues.
When it comes to getting their children help, parents play a crucial role in encouraging them to exercise more and changing unhealthy dietary habits.
But Rhee found that parents' willingness (or lack thereof) to step in on behalf of their kids had a lot to do with their own relationship with their weight in some cases.
When it came to changing their children's diets, parents who were overweight themselves were less likely to be willing to make the necessary dietary changes for their kids.
Rhee suspects that this might have to do with the parents' own -- sometimes failed -- efforts to control their weight through diets.
"Typically, they are not successful," Rhee noted. "I wonder if because of that history they find it difficult to do anything for their kids."
This study adds to existing research that suggests the perception-vs.-reality problem is one the doctors need to actively develop strategies to deal with.
A recent Centers for Disease Control and Prevention report found that nearly half of obese children and teens aren't aware that they are overweight (or underweight, for that matter).
And parents -- particularly of younger children –- might be trying to toe the fine line between acknowledging a problem and protecting their children from potentially physiologically damaging shame.
"You don't want to give these kids complexes," Rhee acknowledged. "But I think you can still address it by talking about trying to eat healthy and 'let's just go out and be active' and not really tying it to weight."