Georgia Southern study shows dangerous disconnect between doctors and parents of overweight children

June 13, 2016

A new Georgia Southern study published in the International Journal of Obesity suggests only a third of the parents of overweight and obese children are being notified about their kids’ unhealthy weight.

The study, “An increasing trend in health-care professionals notifying children of unhealthy weight status,” is an examination of data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2014. In the survey, the parents of obese and overweight children of varying ages were asked “Has a doctor or other health professional ever told you that you (or your child) were overweight?”

And while the survey showed that parent notification rose surely but slowly over 15 years (from 22.12 percent in 1999 to 34.43 percent in 2014), study authors Dr. Jian Zhang, associate professor of epidemiology, and Andrew Hansen, Dr.P.H., assistant professor of community health behavior and education in the Jiann-Ping Hsu College of Public Health, say it’s not enough to curb the rising tide of obesity among America’s children.

“We’ve been discussing an obesity program for almost three decades, but it’s just getting worse and worse,” said Zhang. “We do everything we can, but the impact is very limited. The overall prevalence [of obesity] is just growing.”

Currently, childhood obesity affects 30 percent of all children, and the rate continues to climb for some groups. Research shows that a third of obese preschoolers and children and half of obese adolescents will become obese adults, so why is there so little communication between parents and health care professionals? Zhang and Hansen say the reasons vary.

Hansen says part of the reason could be the parents themselves. Because the survey depended on self-reporting results, the parents of obese and overweight children may have been told, but don’t want to admit their child is obese or overweight. In addition, some parents may not truly perceive their children are overweight.

“They may, as we’ve said in our previous papers about perceptions of obesity, mistrust the physician or the BMI [body mass index] growth charts, and culturally they may not think that applies to their child,” he said.

On the other hand, the doctor may not actually be telling the parent or the child, and there are a few reasons for this as well.

Zhang says most physicians spend seven to nine minutes with a parent and child, discussing a long list of checkpoints recommended by the American Academy of Pediatrics. In such a short amount of time, it’s very difficult to cover everything on the list. In addition, the insurance industry doesn’t generally cover discussions concerning body weight, which makes the doctor even less concerned with the issue.

“Even if the doctor spends five minutes or 10 minutes talking with the parents, there is no way for the insurance to pay that money,” he said.

Zhang said the obesity rate among health care professionals is also a big concern. Their lifestyle and job stressors put them at a higher risk for being overweight and obese compared to others.

“They may feel uncomfortable discussing the body weight issue with patients if they themselves are overweight,” he said.

Hansen says the study didn’t seek to place the blame on the doctor, and hopes it simply highlights the need for parents to be greater participants in their own health care.

“That’s our job in public health — to educate the public about how to be health literate,” he said. “We’re trying to empower them to be more inquisitive about their own health and ask doctors about diagnoses and things that come up.”

In order to defeat childhood obesity, Zhang says it’s going to take not only physicians and parents, but more importantly public health professionals and health care professionals working in tandem to address the problem.

“I believe the salient point for our current study is that we’ve discovered the poor marriage between clinical prevention and public health,” said Zhang. “It doesn’t matter what the public health professional wants to do, we always need the help, the contribution, the input from the physician’s perspective.

“Without their help, we, the public health practitioners, cannot achieve anything.”