Differences between the perceived and actual age of overweight onset in children and adolescents

Objective: Little is known about whether children or their parents can accurately recall the age at which they became overweight. Design, subjects and main outcome measures: We interviewed 64 overweight children (7-18 years old) about their weight history and compared reported age of overweight onset with actual onset, as determined by the age at which the child's measured BMI first exceeded the 95th percentile. Results: Only 28% of children reported overweight onset within 1 year of actual overweight onset. Reported overweight onset age (7.6 ± 2.5y) and actual onset age (5.3 ± 2.5y; P < .001) were not significantly correlated (r² = .03, P = .22). Children who became overweight before 8 years of age tended to report becoming overweight at a later age than actual onset, whereas children who became overweight after 8 years of age tended to report becoming overweight at an earlier age than actual onset (P < .001), with 27% of children either underreporting or overreporting their overweight onset by at least 5 years. Similar results were found when analyzing parent reports of their children's overweight onset. Conclusions: Reported and actual overweight onset ages were uncorrelated in our sample, suggesting that families may not be cognizant of children's growth trajectories. Greater efforts should be made help parents and children understand and track growth patterns with the aim of preventing excessive weight gain.