Parental Awareness of and Agreement With the American Academy of Pediatrics Clinical Practice Guideline for Obesity Treatment

Context: Primary care providers (PCPs) frequently treat children and adolescents with obesity. In 2023, the American Academy of Pediatrics released new clinical practice guidelines (CPG) for the evaluation and treatment of pediatric obesity. The ability for PCPs to implement the guidelines depends, in part, on parental awareness of and agreement with the CPG.

Objective: To describe parental awareness of and agreement with the pediatric obesity CPG.

Study Design and Analysis: An online survey was conducted. Parents answered questions about their awareness of the CPG and agreement with 8 CPG recommendations. They described any personal experiences/beliefs that influenced their feelings towards the CPG. Linear regression and inductive content analysis was used.

Population Studied: Eligibility criteria: age ≥18 years old, US Nationality, fluency in English, and parent to child(ren) <18 years old.

Results: 151 parents responded. Most were female (63%), white (75%), non-Hispanic (91%), married (74%), and completed a bachelor’s degree or higher (55%). Nearly half (44%) screened positive for financial insecurity. Most had overweight or obesity (29% and 34%, respectively), and 15% had a child diagnosed with overweight or obesity by a doctor. Very few parents (5%) were aware of the CPG. Over half of parents agreed with 6 of the 8 CPG recommendations (range 51-74% of parents), whereas fewer parents agreed with the recommendation to offer medications (27%) or surgery (16%). Parents with a higher BMI had lower overall CPG agreement (beta=-0.6, p=0.2); parent age, sex, and financial insecurity did not predict overall CPG agreement. Many parents’ opinions on the CPG were influenced by beliefs not supported by the current scientific understanding of obesity (e.g., lifestyle-focused education is a highly effective treatment for obesity, parents are responsible for and potentially should be punished for pediatric obesity).

Conclusions: Few parents were aware of the CPG, suggesting a need for continued public education of the guidelines. Parents’ perspectives on the CPG were largely based on anecdotal experiences and commonly held “obesity myths” that focus on parental responsibility, personal choice, and lifestyle education as a highly effective treatment for obesity. To improve uptake of the CPG without worsening weight stigma/bias, PCPs should continue efforts to educate parents about the new guidelines while simultaneously addressing commonly held obesity myths.