Abstract
Silhouettes are used in the self-assessment of one's body size, shape and satisfaction. This technique can be helpful in intervention studies and in household studies in which body size measurements are not feasible. Despite its popularity, few studies have validated the Stunkard Figure Rating Scale (SFRS) to assess body image (BI) or nutritional status (NS). The present study assessed the agreement between self-assessment of BI by SFRS and measured BMI in adults from a national household survey in Brazil (n = 11247; 57.2% women, aged 20-99y). The subjects were asked to choose a silhouette from the SFRS that most resembled their current status prior to measures of body mass and stature. BMI-derived NS was then matched to the SFRS. The prevalence of overweight and obesity (OB) was 34.4 and 19.0%, respectively. Weighted kappa between SFRS and BMI was 0.45 and 0.43 and Spearman's correlation coefficient was 0.64 and 0.59 for women and men, respectively. Sex-specific receiver operating curves indicated that the silhouettes correctly (area under the curve > 0.80) identified OB and underweight (UW). In conclusion, SFRS provides only reasonable results when estimating the BMI distribution but it works well to identify OB and UW in the Brazilian adult population.
Highlights
Self-assessment of body image is a multidimensional construct by which individuals describe the internal representations of their body structure and physical appearance in relation to themselves and others[1]
The frequency of body mass index (BMI) that corresponds to underweight was low in both sexes, with values of 8.7% and 7.5% in women and men, respectively
Mean BMI increased as the silhouette numbers increased and all chosen silhouettes had obese subjects
Summary
Self-assessment of body image is a multidimensional construct by which individuals describe the internal representations of their body structure and physical appearance in relation to themselves and others[1]. The use of silhouettes has become popular to measure the size, shape and satisfaction of one’s body[1]. To this end, the series of silhouettes introduced by Stunkard et al.[4] to assess the parents weight status of adoptees in the Danish Adoption Register, later named as the Stunkard Figure Rating Scale (SFRS), have been used extensively both in clinical[5,6] and epidemiological[7,8] studies. Most published studies have focused on the relationship between the SFRS and BMI to diagnose eating disorders or body distortion/satisfaction and have shown that people, especially women, tend to choose skinner silhouettes than their BMI would suggest[1]
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