The Goldilocks Syndrome and The New Normal

Who's been eating MY porridge_

Childhood Obesity News has been discussing how, for some time now, people have been referring to obesity as “the new normal.” This normalization is related to the growth of the “Goldilocks Syndrome.” The term has more than one meaning, but in the context of childhood obesity, it refers to the tendency of parents to perceive their child’s weight as within the normal range, despite evidence to the contrary.

In all such studies, parents are asked some version of the “Goldilocks question.” Do they see their child’s weight as too much, too little, or just right? (Apparently, some researchers also offer “don’t know” as an option.) This is important because if parents do not even recognize that a child is overweight, how can they be willing or motivated to make changes? With such a monumental amount of delusion going on, policymakers and clinicians need to take that factor into account if they are to convince parents of the need for intervention.

The obliviousness of parents has been recognized for a while, and it is getting worse. In 2010, about 70 percent of parents of fat babies and toddlers did not realize that their children were overweight. Only a fraction of them had been alerted by their pediatricians, and if the doctors won’t sound the alarm, who will? But health care workers are only part of the equation, because there is more than one kind of unawareness. There is not knowing, and there is refusal to know.

Parents Don’t Want to Hear Doctors Sounding the Obesity Alarm

Since authorities have started to be more active in trying to warn parents, there has been backlash. Doctors and schools have caught some flak. An offended parent may decide that the answer is not to help the child slim down, but to change doctors. Or change schools, or explore the possibility of suing the school system. The conflict is still in progress, and sometimes looks like a no-win situation. Last year, Cari Romm wrote for The Atlantic:

Past research has also pointed out this glaring parental blind spot: An analysis of 69 separate studies conducted between 1990 and 2012, published earlier this year in Pediatrics, concluded that more than half of all parents underestimate their children’s weight.

Romm suggests that, at least in some places, the dynamic has changed. Again, there is not knowing, and there is refusal to know, which is different without being better. Another study confirmed that even parents who have been tipped off by a doctor about their children’s obesity don’t necessarily worry about it. Romm writes:

The majority of parents, 93.5 percent, correctly recognized that their children were, in fact, overweight or obese—but nearly 30 percent said they didn’t see their children’s weight as a problem, and roughly the same number rated their children’s health as “very good” or “excellent.”

This dissonance, according to pediatrician and lead study author Kyung Rhee, may have to do with what she calls “the normalization of obesity.”

The blindness is also something of a cultural phenomenon, which is nothing new. For some reason, boys are more likely than girls to be perceived as normal weight when they are not. A Goldilocks study in the United Kingdom found that:

Parents were more likely to underestimate a child’s weight if the child was black or South Asian, male, from a deprived background or older (aged 10 to 11 years).

A similar study in America, conducted by NYU’s Langone Medical Center, tracked nearly 7,000 children for at least five years. Impossible as it seems to believe, more than 95 percent of the parents of overweight kids thought they were at just about the right weight. Reminiscent of the British study, African-American and low-income parents were the least likely to realize that their children were obese.

Even the most conscientious and vigilant parents can be caught off guard. Dietician Heather Neal wrote that she and her husband were both at healthy weights when their child was conceived. During pregnancy she ate the right things and stayed inside the recommended weight gain guidelines. Once born, their son was diagnosed with “failure to thrive” but then he started to grow. He ate vegetables and was not given sweets or junk food. Every day of his babyhood included active physical play. It should have been perfect. Neal wrote:

But here we are, almost three years later, with a child officially categorized as “obese”…It was obvious how big he was, but it was refreshing because we could finally feel convinced he was well-nourished and not starving all the time…When you see opposite extremes, it gets hard to distinguish what’s normal and just different.

Your responses and feedback are welcome!

Source: “Study: Many Parents Are In Denial About Their Kids’ Obesity,” TheAtlantic.com, 07/25/14
Source: “_Many parents fail to recognize signs of childhood obesity,” Healio.com, 03/31/15 Source: “’Goldilocks syndrome’ means parents are denial about their overweight children,” Telegraph.co.uk, 05/10/15
Source: “7 Things I’ve Learned from Having an Overweight Toddler,” Babble.com, October 2014
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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
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Presentations

Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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