title: Is my kid out of size? Indian mothers' desirability bias in evaluation of their children's weight.
abstract: OBJECTIVE
  To quantify mothers' social desirability bias with respect to their children's weight in a cross-regional Indian setting.
  
  
  METHODS
  The OBEY-AD was a cross-sectional study which has been realized in 7 Indian cities (Bengaluru, Mumbai, Chennai, Hyderabad, Kolkata, New Delhi and Surat), enroling 1,680 children aged 3-11 y of which 50% were females. Children's BMI scores were computed, standardized according to WHO growth charts and categorized as Normal, Overweight, Obese and Underweight. Mothers were asked to judge the weight status of their children through an iconographic test, indicating the shape, which better mirrors the size of their kids. Socio-demographic data, especially employment, income and education, was accessed by administrating a cross-sectional questionnaire to the mothers, involved for the study.
  
  
  RESULTS
  Overall, 369 children resulted as obese or overweight (23.5%). Out of them, 75% (278) were not recognized as such by their mothers. Such figures range from up to 76% in Chennai and Surat down to 72% in Hyderabad, Kolkata, New Delhi and Mumbai. Overall agreement between perceived and desired weight status of children was very poor (p < 0.001). Surprisingly, overall 10% of overweight/obese children were considered as even too lean by their mothers. Misperception of children's weight status seemed to be significantly related to urban differences and socio-economic status.
  
  
  CONCLUSIONS
  This study quantifies the extent of the so-called social desirability bias, namely mother's unconscious attitude to adapt empirical evidence to more culturally legitimized ideal-types of what their children's weight status is expected to be. Its association with westernized representations of leanness as evaluation criteria for beauty has important policy implications.
authors.affiliation: Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Via Loredan, 18, 35121, Padova, Italy.
authors.forename: Alexander
authors.initials: A
authors.lastname: Hochdorn
authors.forename: Ileana
authors.initials: I
authors.lastname: Baldi
authors.forename: Elizabeth Cherian
authors.initials: EC
authors.lastname: Paramesh
authors.forename: Malathi
authors.initials: M
authors.lastname: Kumar
authors.forename: Achal
authors.initials: A
authors.lastname: Gulati
authors.forename: Dario
authors.initials: D
authors.lastname: Gregori
mesh_terms: D001290:Attitude; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D009035:Mothers / Q000523:psychology*; D050177:Overweight; D012928:Social Desirability; D013851:Thinness