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Kids With Higher BMIs May Not Actually Know They’re Overweight

Children with high BMIs have one strange thing in common — They don't see size.

Children who are overweight might be more likely to underestimate their body size than other children, and this gets worse as they get older. Though that may seem like some strange psychological upside, the implications are that the heavier kids are less likely to consider healthy lifestyle changes if they’re in denial of an issue to begin with. They’re not just heading down the road towards emotional distress, heart disease, and a shorter lifespan — they have the blinders on.

“To put it simply, first we have to acknowledge that we have a problem before we can do something about it,” study coauthor Silje Steinsbekk of Norwegian University of Science and Technology, said in statement. “This also applies to parents: if they don’t recognize that their children have a weight problem, they won’t seek help for it.”

While there’s a lot of research devoted to the overestimation of body size, particularly related to eating disorders like anorexia, very few studies have looked at what happens when people underestimate their weight. However, at least two studies have linked underestimation with being overweight. Given that more than one in three children in America are obese, the role underestimation could play warrants more scientific attention.

To get more information, Steinsbekk and colleagues followed 793 Norwegian children from age 6 to age 10. At ages 6, 8, and 10, researchers collected data about children’s height, weight, and body mass index (BMI). They also scored children’s self-perceptions by showing them seven pictures of boys and girls (with known BMIs) and asked kids to identify who looked most like them. Researcher then measured the difference between who kids picked, and their own stats.

Although results showed that kids were generally more likely to overestimate their body size, high BMIs predicted underestimation, even when researchers controlled for other factors, such as previous underestimation. Boys were more prone to underestimation of body size than girls comparatively, and the largest children in at the end of the study showed an increase in underestimation overtime.

The difference between causation and correlation are important to note, as the findings indicate a relationship between BMI and underestimation, but by no means conclude that underestimation causes obesity or the other way around. There are several variables that could contribute to underestimation that researchers did not control for in this particular study, like the BMI of children’s classmates. (When everyone else around you is fatter, you think you’re doing alright.)

Steinsbekk suspects that this underestimation may be adaptive for kids, in order to offset some of the psychological stress associated with being overweight. “It’s reasonable to imagine that underestimating protects you from acknowledging that your body is bigger than you want, and that can be quite practical,” he says. Still, that doesn’t mean parents get let off the hook in the same way. Denial may be protective for children to a point, but for parents it could hinder important changes that need take place a healthier life.

“For children, the parents’ acknowledgment of the problem is what’s most important. Parents are the ones who need to make the necessary adjustments to promote good health.”