Evaluating Parental Perception and Confidence Managing Obesity-Related Behaviors Among Children with Severe Early-Onset Obesity in a Tertiary Care Clinic

<b><i>Background:</i></b> Children with severe early-onset obesity (defined as a body mass index >120% of the 95th percentile before age 5) are a high-risk population often displaying disruptive food-related behaviors. This study assessed: (i) caregivers' confidence addressing obesity-related behaviors in children with severe early-onset obesity and (ii) differences in behavior perceptions between children with and without impaired satiety. <b><i>Methods:</i></b> Caregivers from a specialized pediatric obesity clinic completed the Lifestyle Behavior Checklist (LBC), a 25-question tool, evaluating their perceptions and confidence managing obesity-related behaviors. Impaired satiety diagnoses were based on clinical ascertainment of at least three abnormal eating behaviors across multiple settings. Data were analyzed using appropriate statistical tests. <b><i>Results:</i></b> A total of 89 caregivers completed the LBC. Parents felt least confident managing four of the top five perceived most problematic behaviors: excessive eating, requesting extra portions, unhealthy snacking, and eating too quickly. Parents of children with impaired satiety rated 16 behaviors as significantly more problematic (<i>Q</i>-value <0.05) and reported lower overall confidence in managing these behaviors compared with parents of children without impaired satiety (<i>Q</i>-value = 0.04). Despite these differences, both groups identified excessive eating as the most problematic behavior and the one they were least confident in managing. <b><i>Conclusion:</i></b> Parents of children with severe, early-onset obesity, reported difficulty managing food-related behaviors. Children with severe, early-onset obesity and impaired satiety displayed similar, but more pronounced, problematic lifestyle-related behaviors compared with those without satiety impairments. Future research should determine if behavior-specific counseling would be helpful to parents of children with severe, early-onset obesity.