Background: Few studies have studied parental perceptions in different settings of their children's weight in relation to objective measurements.

Aim: To evaluate parental perceptions of their child's weight category in relation to anthropometric measurements.

Key Methods: This was cross-sectional study of 16 220 children, 2–9 year of age, from eight European countries. Parents completed a questionnaire on their perception of the children's weight and concern for future weight deviations. Objective children's weight categories from the International Obesity Task Force were used.

Results: Parental weight perception corresponded overall to children's mean body mass index (BMI) z-scores, but there were exceptions, e.g. 63% of parents to children with overweight marked ‘proper weight’. One-third of the total indicated concern for future underweight, most often in parents of children in the overweight category. The strongest predictor for accurate parental weight perception for children with overweight and obesity was BMI z-score (odds ratio [OR] 7.2, 95% confidence interval [CI] 6.1–8.7). Compared to Southern Europe, ORs for accurate parental weight perception were 4.4 (95% CI 3.3–6.0) in Northern Europe and 3.4 (95% CI 2.7–4.2) in Central Europe.

Conclusion: Parents of children categorized as being overweight or obese systematically underestimated weight category. Parents differed regionally in accurate perception of weight.