Tipping the Scales on Obesity Awareness

Dr. Jian Zhang, associate professor of epidemiology in the Jiann-Ping Hsu College of Public Health, is bringing national awareness to the obesity pandemic in the United States through a series of highly publicized research articles about the misperceptions of obesity among children, adolescents and their parents.
It’s an idea he discovered through his own misperceptions about his son.

“My younger son is relatively slim compared to his friends,” he said. “Both my wife and myself were concerned that the little one might have an underweight issue socially and this might not be good for a boy. However, when we compared the little one’s weight and height with a growth chart, biologically, he is actually overweight and almost obese. Both my wife and myself are public health professionals, and we are still struggling with the discrepancy between socially and biologically acceptable norms.”

Zhang is not alone in his struggle. In an examination of data from the National Health and Nutrition Examination Survey (NHANES), he and his research team found that the parents of preschoolers and school-aged children were getting remarkably worse at perceiving whether or not their child is overweight or obese. Across the studies, Zhang observed a steep decline in this ability — a 30 percent decline — in less than 20 years.

And while the issue of body weight misperception has been understood among researchers for a long time, the results still surprised him.

“What most surprised me was the trend of the kids as well as the parents to refuse to admit their body weight was a problem,” he said. “The declining trend really surprised me. That might be the reason our publication drew so much national attention: the decline within just such a short time period — 12 or 15 years — a decline of 30 percent. That’s a really huge decline.”

The national media took notice, and Zhang and his team found their research discussed in such outlets as The Washington Post, TIME magazine, U.S. News and World Report and “The TODAY Show.”

Zhang and his team continue to research body weight misperceptions from different angles, and while he hopes that the results continue to raise awareness, he says that he hasn’t found the best way to communicate the message to parents and their children.

“Right now, one in three adults are obese,” he said. “One out of three are overweight. That means two out of three adults are in the range of unhealthy body weight. So, we have not yet figured out the most effective communication between the parents and the kids, given that the parents themselves are also struggling with body weight. So if the parents are struggling with body weight, what they say is much less powerful to their kids.”

Zhang believes the key to this communication is the medical doctor, who represents a more trustworthy source of expertise, but who is also limited in the amount of time he or she can visit a patient. It’s a difficult problem, but in spite of the difficulties, Zhang says he has seen rays of hope.

“In Georgia, for example, we definitely see a decline in obesity prevalence among the school kids and among adolescents,” he said. “At least from 2011 to 2013, we saw a clearly declining trend that’s really an encouraging sign. That means what we’re doing is working. We just need to do more.” — Doy Cave