Interpreting Divergent Child Obesity Surveillance Signals During the COVID-19 Pandemic: Comparing Parent-Reported NSCH and Measured NHANES, United States, 2016-2023.

This study assessed whether parent-reported national surveillance identified the change in child obesity that measured surveillance indicated across the COVID-19 pandemic. Using six waves of the National Survey of Children's Health (NSCH; 2016-2023; n = 153,656) and two National Health and Nutrition Examination Survey (NHANES) releases bracketing the pandemic (2017 to March 2020 and August 2021 to August 2023; n = 4914), we estimated weighted obesity prevalence (BMI-for-age at or above the 95th percentile) among children aged 6-17. Parent-reported prevalence was 17.0% both before and after the pandemic. Measured prevalence was 21.3% prepandemic and 22.7% postpandemic, a difference whose confidence interval included zero. The measured-minus-reported gap was 4.3 and 5.7 percentage points pre- and postpandemic, respectively, and widened modestly but not significantly. A flat parent-reported trend is not, on its own, evidence that prevalence remained stable.