Underestimation Of Body Mass Index Research Articles

Measured vs self-reported overweight/obesity in the Italian adult population: CUORE Project 2018-19

Abstract Background In monitoring population health and the effectiveness of public health strategies, the body mass index (BMI) is often assessed within national surveys from self-reported height and weight rather than measured values. Using data collected within a recent health examination survey (HES), the discrepancies between self-reported and measured values were assessed, and correction models were estimated and implemented on national interview survey data. Methods Within the CUORE Project, the Italian National Institute of Health conducted the HES 2018-2019 measuring height and weight as well as collecting data on self-reported values in random samples of general population aged 35-74 years residing in ten (of 20) Italian regions distributed in the North, Centre and South: 1033 men and 1061 women. Results Self-reported and measured data comparison showed greater differences in mean values of height than weight and in women than in men (height +2 cm in men and +3.2 in women; weight -0.7 kg and -1.4 kg, respectively) and a corresponding underestimation of BMI (-0.7 kg/m2 and -1.4 kg/m2, respectively). Differences were stable across age groups and educational levels, except for height discrepancy, which was greatest in women aged 65-74 years. Self-reported vs measured prevalence were: normal weight 39.7%-33.3% in men and 54.8%-44.7% in women, overweight 45.8%-46.1% and 26.0%-29.2%, obesity 13.8%-20.1% and 15.7%-23.9%. Linear regression models adjusted by sex and age classes were assessed for height and weight (R2 > =0.92) and implemented to estimate adjusted BMI and normal weight/overweight/obesity prevalence on the national multi-purpose interview survey data collected by the Italian National Institute of Statistics. Conclusions To provide more accurate prevalence of normal weight, overweight and obesity, self-reported values could be adjusted using correction models developed on the basis of the relationship between self-reported and measured height and weight values. Key messages • Discrepancies between self-reported and measured values of height and weoght were found. • Self-reported values could be adjusted using correction models developed on the basis of the relationship between self-reported and measured height and weight values.

Discrepancies in self-reported and measured anthropometric measurements and indices among older Australians: prevalence and correlates

BackgroundAnthropometric measurements and indices such as weight, height and Body Mass Index (BMI) are often used to assess overall health and nutritional status. Clinicians and epidemiologists often rely on self-reported weight and height to measure BMI. Differences between self-reported and measured weight and height can lead to differences between self-reported and measured BMI, biasing relative risks of diseases associated with differential BMI.MethodsApplying regression analysis to a large nationally representative survey data with contemporaneous self-reports and measurements on 3412 individuals aged 65 or over, we provided estimates of the difference between self-reports and measurements of weight, height and BMI for older Australians, analysing demographic, socioeconomic and health correlates of estimated differences.ResultsWe found both males and females underestimated weight, overestimated height and underestimated BMI and there was some evidence these differences increased with age. There was also evidence that these differences were associated with high levels of education and household composition.ConclusionAlthough average differences were small, for many individuals the differences may be significant, indicating measurements should be taken in clinically focused research and practice. This is important as systematic underestimation of BMI in older adults can have implications for estimating the size of populations at risk of many health conditions, including diabetes, hypertension and functional limitations.

Association of neighborhood characteristics with pertussis diagnosis in a retrospective cohort of children born in Philadelphia, Pennsylvania

Body mass index (BMI) derived from self-reported height and weight is often used to study adiposity and its health implications. However, misestimates of BMI from self-reported data have been observed. This study adds to the literature by demonstrating how anthropometric misreporting patterns differed by sex and changed across time in a nationally representative cohort, as well as examining behavioral/psychological correlates of biases in BMI.Misreporting of height and weight (and thus BMI) from adolescence to adulthood in the United States was studied using the National Longitudinal Study of Adolescent to Adult Health (1996–2008). Behavioral/psychological characteristics possibly associated with errors in BMI were analyzed with fixed-effects models.Different patterns of anthropometric misreporting resulted in larger underestimation of BMI among females than males at the beginning waves, but females saw a reduction by the last wave. Males did not see such a decrease, and their error, at 0.75 BMI units by 2008, was comparable to that of females. For both sexes, body image perception was a significant predictor of biases in BMI.From adolescence to adulthood, anthropometric reporting patterns changed, and its variation differed by sex. Nevertheless, errors in BMI were similarly associated with behavioral/psychological characteristics.

Objective vs self-report assessment of height, weight and body mass index: Relationships with adiposity, aerobic fitness and physical activity.

Researchers, policymakers and clinicians commonly use height and weight to determine body mass index (BMI) and classify weight status. Self-report measures are widely used but often result in misreported height and weight and, consequentially, underestimation of BMI and-potentially-weight status misclassification. The purpose of this study was to examine differences in objective and self-reported height, weight and BMI values and to find whether discordance is associated with other anthropometric measures, fitness and physical activity. Data were collected from college students through: (a) a pre-consultation online questionnaire where participants self-reported gender, height and weight; (b) an objective fitness assessment that assessed height, weight, body fat percentage, abdominal girth and predicted aerobic fitness; and (c) a post-assessment electronic survey that assessed physical activity. Parametric and non-parametric analyses examined differences between groups. Objective and self-reported height and weight data were collected from 1061 participants, 224 of whom also provided physical activity data. Women significantly under-reported weight (P = .003, η2 = 0.02), and both genders over-reported height (P < .001, η2 ≥ 0.07), resulting in a significant difference between BMIs calculated using the different measures (P < .001, η2 ≥ 0.07) and the weight status misclassification of ~15% of participants. Significant differences were found in anthropometrics, fitness and physical activity based on reporting differences for weight (P ≤ .015) and BMI (P ≤ .015). Students demonstrated a tendency to under-report weight and over-report height, resulting in weight status misclassification. Those who under-reported weight tended to be in poorer health as indicated by lower aerobic fitness and higher abdominal girth and body fat percentage in particular. Further research is required to establish the link between under-reporting weight and over-reporting physical activity.

Regression Models to Predict Corrected Height, Weight, and Obesity Indicators among University Students in Beijing, China

ObjectiveWhereas data collection on subjective anthropometric measures is inexpensive and sometimes may be the only feasible option for large-scale population-based surveys, self-reported height and weight can be susceptible to measurement error and social desirability bias. In this study, we aimed to assess the level of discrepancy between self-reported and device-measured height, weight, and obesity indicators, and to construct regression models to predict corrected anthropometric measures using self-reported data. MethodsPaper-and-pencil-based health surveys were administered to all freshmen enrolled in Tsinghua University in Beijing, China. Freshmen's height and weight were measured by trained staff using stadiometer and digital scale within one week following survey completion. Robust regressions were performed to predict corrected height, weight, body mass index (BMI), and overweight and obesity prevalence using self-reported data (N = 16,675). ResultsMale freshmen over-reported both height and weight, whereas female freshmen over-reported height but under-reported weight. Both resulted in underestimation of BMI and overweight prevalence. The predicted values based on robust regressions substantially reduced the discrepancy between self-reported and objectively-measured height, weight, BMI, and overweight prevalence. ConclusionsParsimonious regression models could be useful in obesity surveillance by predicting corrected anthropometric measures using self-reported data.

Measuring the bias, precision, accuracy, and validity of self-reported height and weight in assessing overweight and obesity status among adolescents using a surveillance system.

BackgroundEvidence regarding bias, precision, and accuracy in adolescent self-reported height and weight across demographic subpopulations is lacking. The bias, precision, and accuracy of adolescent self-reported height and weight across subpopulations were examined using a large, diverse and representative sample of adolescents. A second objective was to develop correction equations for self-reported height and weight to provide more accurate estimates of body mass index (BMI) and weight status.MethodsA total of 24,221 students from 8th and 11th grade in Texas participated in the School Physical Activity and Nutrition (SPAN) surveillance system in years 2000–2002 and 2004–2005. To assess bias, the differences between the self-reported and objective measures, for height and weight were estimated. To assess precision and accuracy, the Lin’s concordance correlation coefficient was used. BMI was estimated for self-reported and objective measures. The prevalence of students’ weight status was estimated using self-reported and objective measures; absolute (bias) and relative error (relative bias) were assessed subsequently. Correction equations for sex and race/ethnicity subpopulations were developed to estimate objective measures of height, weight and BMI from self-reported measures using weighted linear regression. Sensitivity, specificity and positive predictive values of weight status classification using self-reported measures and correction equations are assessed by sex and grade.ResultsStudents in 8th- and 11th-grade overestimated their height from 0.68cm (White girls) to 2.02 cm (African-American boys), and underestimated their weight from 0.4 kg (Hispanic girls) to 0.98 kg (African-American girls). The differences in self-reported versus objectively-measured height and weight resulted in underestimation of BMI ranging from -0.23 kg/m2 (White boys) to -0.7 kg/m2 (African-American girls). The sensitivity of self-reported measures to classify weight status as obese was 70.8% and 81.9% for 8th- and 11th-graders, respectively. These estimates increased when using the correction equations to 77.4% and 84.4% for 8th- and 11th-graders, respectively.ConclusionsWhen direct measurement is not practical, self-reported measurements provide a reliable proxy measure across grade, sex and race/ethnicity subpopulations of adolescents. Correction equations increase the sensitivity of self-report measures to identify prevalence of overall overweight/obesity status.

Web-based self-reported height, weight, and body mass index among Swedish adolescents: a validation study.

BackgroundWeb-collected height and weight are increasingly used in epidemiological studies; however, the validity has rarely been evaluated.ObjectiveThe aim of the study was to validate self-reported height, weight, and corresponding body mass index (BMI) among Swedish adolescents aged approximately 16 years. A secondary aim was to investigate possible prediction factors for validity of self-reported BMI.MethodsThe study included 1698 adolescents from the population-based cohort BAMSE. Height and weight were collected through a Web-based questionnaire and subsequently measured using standard procedures. Differences between reported and measured height, weight, and corresponding BMI were compared by t tests and agreement was evaluated by Pearson correlation and Bland-Altman plots. Multivariable linear regression analysis was used to investigate whether lifestyle and demographic factors predicted validity of self-reported BMI.ResultsOn average, weight was underestimated by 1.1 kg and height was overestimated by 0.5 cm, leading to an underestimation of BMI by 0.5 kg/m2. Correlation coefficients were .98 for height, .97 for weight, and .94 for BMI, and highly significant. Females underestimated weight to a higher extent than males and overweight and obese participants underestimated weight to a higher extent than normal-weight participants, which resulted in higher underestimation of BMI. Underweight participants, on the contrary, overestimated weight and correspondingly BMI. Overall, a high proportion of participants were classified into the correct BMI category; however, among overweight and obese participants, only 60.2% (139/231) and 46% (20/44) were correctly classified, respectively. In the multivariable prediction model, only gender and BMI status significantly predicted discrepancy between reported and measured BMI.ConclusionsWeb-collected BMI may be used as a valid, quick, and cost-effective alternative to measured BMI among Swedish adolescents. The accuracy of self-reported BMI declines with increasing BMI and self-reported BMI should not be used to estimate the prevalence of overweight or obesity.

Stature estimation using the knee height measurement amongst Brazilian elderly.

Stature is an important variable in several indices of nutritional status that are applicable to elderly persons. However, stature is difficult or impossible to measure in elderly because they are often unable to maintain the standing position. A alternative is the use of estimated height from measurements of knee height measure. This study aimed to evaluate the accuracy of the formula proposed by Chumlea et al. (1985) based on the knee of a Caucasian population to estimate the height and its application in calculation of body mass index in community- dwelling older people residents in Viçosa, Minas Gerais, Brazil. The sample included 621 elderly aged 60 years old and older, living in the community. Measures of weight, height and knee height (KH) were taken and Body Mass Index (BMI) was calculated with the measured weight and estimated. The Student`s t-test was used for comparison of measurements of height between the genders. For the comparison of estimated and measured values it was used paired t-test and also the methodology proposed by Bland and Altman to compare the difference between measurements. To evaluate the agreement between the classifications for BMI was used Cohen's Kappa. The average values obtained from KH were higher than those measured in the whole sample and women. There underestimation of BMI in females and also in the whole. The present results suggest that the equation Chumlea was not adequate to estimate the height of the sample in question, especially for women.

Comparison of bias resulting from two methods of self-reporting height and weight: a validation study.

ObjectivesTo contrast the validity of two modes of self-reported height and weight data.DesignSubjects’ self-reported height and weight by mailed survey without expectation of subsequent measurement. Subjects were later offered a physical exam, where they self-reported their height and weight again, just prior to measurement. Regression equations to predict actual from self-reported body mass index (BMI) were fitted for both sets of self-reported values. Residual analyses assessed bias resulting from application of each regression equation to the alternative mode of self-report. Analyses were stratified by gender.SettingUpstate New York.ParticipantsSubjects (n = 260) with survey, pre-exam and measured BMI.Main outcome measuresPrevalence of obesity based on two modes of self-report and also measured values. Bias resulting from misapplication of correction equations.ResultsAccurate prediction of measured BMI was possible for both self-report modes for men (R 2 = 0.89 survey, 0.85 pre-exam) and women (R 2 = 0.92 survey, 0.97 pre-exam). Underreporting of BMI was greater for survey than pre-exam but only significantly so in women. Obesity prevalence was significantly underestimated by 10.9% (p < 0.001) and 14.9% (p < 0.001) for men and 5.4% (p = 0.007) and 11.2% (p < 0.001) for women, for pre-exam and survey, respectively. Residual analyses showed that significant bias results when a regression model derived from one mode of self-report is used to correct BMI values estimated from the alternative mode.ConclusionsBoth modes significantly underestimated obesity prevalence. Underestimation of actual BMI is greater for survey than pre-exam self-report for both genders, indicating that equations adjusting for self-report bias must be matched to the self-report mode.

Estimation Bias: Body Mass and Body Height in Endurance Athletes

Body Mass Index is associated with endurance performance in athletes. Reported and measured values of body mass and body height in 1,618 endurance athletes (1,358 men, 260 women) showed that men and women both underestimated their body mass and overestimated their body height, leading to an underestimation of Body Mass Index. There were age and sex differences in estimates of height and weight; for both women and men, underestimation of Body Mass Index amounted to 0.4 kg/m2. Master athletes tended to underestimate their body mass and overestimate their body height thus leading to significant differences between estimated and measured Body Mass Index. However, the magnitude of underestimation of BMI probably has a negligible influence on performance predictions. The differences between measured and estimated body mass, height, and BMI were within the range of normal daily variation, and for body height even within the precision of the measurement (0.5 cm).

Temporal changes in bias of body mass index scores based on self-reported height and weight

Objectives:To investigate temporal changes in the bias associated with self-reported (as opposed to measured) body mass index (BMI) and explore the relationship of such bias to changing social attitudes towards obesity.Methods:Using data from the National Health and Nutrition Examination Survey covering two time periods, 1988–1994 and 2005–2008, discrepancy scores between self-reported vs measured BMI were generated. Changes in the sensitivity of BMI categories based on self-reports were examined for six weight groups, both for the US adult population as a whole and major demographic groups. Linear regression models were used to examine temporal changes in average bias, as well as attitudes about weight within each weight category and by demographic group.Results:Between 2005–2008 and 1988–1994, the bias towards underestimation of a person's BMI based on interview responses has declined among obese individuals, a trend evident in virtually all demographic subgroups explored. Conversely, most demographic groups showed little change in the extent of bias among underweight and normal-weight individuals. Although the 2005–2008 survey respondents underestimated their measured BMI more than the 1988–1994 respondents, this shift can be entirely explained by the increased prevalence of obesity in more recent years. In fact, obese individuals in 2005–2008 were less likely to overreport their height and underreport their weight than their counterparts in the 1988–1994. Evidence from responses to questions about ideal weight and desire to lose weight point in the direction of a shift in social attitudes, which may make it easier to ‘admit' to greater weight in surveys.Conclusion:Over the past 20 years, the bias in self-reported height and weight has declined leading to more accurate BMI categorizations based on self-report. This change is likely to affect efforts to find correction factors to adjust BMI scores based on self-reported height and weight.

Validity and predictors of BMI derived from self-reported height and weight among 11- to 17-year-old German adolescents from the KiGGS study

BackgroundFor practical and financial reasons, self-reported instead of measured height and weight are often used. The aim of this study is to evaluate the validity of self-reports and to identify potential predictors of the validity of body mass index (BMI) derived from self-reported height and weight.FindingsSelf-reported and measured data were collected from a sub-sample (3,468 adolescents aged 11-17) from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). BMI was calculated from both reported and measured values, and these were compared in descriptive analyses. Linear regression models with BMI difference (self-reported minus measured) and logistic regression models with weight status misclassifications as dependent variables were calculated.Height was overestimated by 14- to 17-year-olds. Overall, boys and girls under-reported their weight. On average, BMI values calculated from self-reports were lower than those calculated from measured values. This underestimation of BMI led to a bias in the prevalence rates of under- and overweight which was stronger in girls than in boys. Based on self-reports, the prevalence was 9.7% for underweight and 15.1% for overweight. However, according to measured data the corresponding rates were 7.5% and 17.7%, respectively. Linear regression for BMI difference showed significant differences according to measured weight status: BMI was overestimated by underweight adolescents and underestimated by overweight adolescents. When weight status was excluded from the model, body perception was statistically significant: Adolescents who regarded themselves as 'too fat' underestimated their BMI to a greater extent. Symptoms of a potential eating disorder, sexual maturation, socio-economic status (SES), school type, migration background and parental overweight showed no association with the BMI difference, but parental overweight was a consistent predictor of the misclassification of weight status defined by self-reports.ConclusionsThe present findings demonstrate that the observed discrepancy between self-reported and measured height and weight leads to inaccurate estimates of the prevalence of under- and overweight when based on self-reports. The collection of body perception data and parents' height and weight is therefore recommended in addition to self-reports. Use of a correction formula seems reasonable in order to correct for differences between self-reported and measured data.

Validation of self-reported anthropometrics in the Adventist Health Study 2

BackgroundRelying on self-reported anthropometric data is often the only feasible way of studying large populations. In this context, there are no studies assessing the validity of anthropometrics in a mostly vegetarian population. The objective of this study was to evaluate the validity of self-reported anthropometrics in the Adventist Health Study 2 (AHS-2).MethodsWe selected a representative sample of 911 participants of AHS-2, a cohort of over 96,000 adult Adventists in the USA and Canada. Then we compared their measured weight and height with those self-reported at baseline. We calculated the validity of the anthropometrics as continuous variables, and as categorical variables for the definition of obesity.ResultsOn average, participants underestimated their weight by 0.20 kg, and overestimated their height by 1.57 cm resulting in underestimation of body mass index (BMI) by 0.61 kg/m2. The agreement between self-reported and measured BMI (as a continuous variable), as estimated by intraclass correlation coefficient, was 0.97. The sensitivity of self-reported BMI to detect obesity was 0.81, the specificity 0.97, the predictive positive value 0.93, the predictive negative value 0.92, and the Kappa index 0.81. The percentage of absolute agreement for each category of BMI (normoweight, overweight, and obese) was 83.4%. After multivariate analyses, predictors of differences between self-reported and measured BMI were obesity, soy consumption and the type of dietary pattern.ConclusionsSelf-reported anthropometric data showed high validity in a representative subsample of the AHS-2 being valid enough to be used in epidemiological studies, although it can lead to some underestimation of obesity.

Schätz- und Messwerte von Größe und Gewicht bei Jugendlichen

The aim of this study was to assess the validity of self-reported height and weight and resulting body-mass-index (BMI) in adolescents, to identify influencing factors and to generate appropriate algorithms for the correction of self-reported values. In the Kiel Obesity Prevention Study (KOPS) height and weight were assessed in 2,706 12- to 17-year-old adolescents by self-report and by measurements. Differences between self-reported and measured values were calculated. Algorithms for correction of self-reported data were generated in a random sample (n=941) and validated in another random sample (n=946). Overestimation of height and underestimation of weight resulted in a remarkable underestimation of BMI. Girls underestimated BMI more than boys (-0.8±1.0 kg/m² vs. -0.4±1.1 kg/m²; p<0.01), overweight adolescents underestimated more than normal weight adolescents (boys: -1.4±1.4 kg/m² vs. -0.3±0.9 kg/m²; p<0.01; girls:-1.6±1.3 kg/m² vs. -0.7±0.8 kg/m²; p<0.01). Prevalence of overweight and obesity was underestimated by 2.0% and 1.5%, respectively, in boys and by 2.2% and 2.0%, respectively in girls. Differences between self-reported and measured values were influenced by gender and weight status. Correction of self-reported data resulted in approaching the valid overweight prevalence. However, underestimations persisted. Self-reported height, weight and BMI calculated from these values are discrepant from measured data and cause underestimation of the prevalence of overweight and obesity in adolescents. Correction of self-reported values is possible. However, valid data can only be assessed by measurements of height and weight.

SELF‐REPORTED VERSUS MEASURED HEIGHT AND WEIGHT IN THE HEALTH AND RETIREMENT STUDY

SELF‐REPORTED VERSUS MEASURED HEIGHT AND WEIGHT IN THE HEALTH AND RETIREMENT STUDY

Self-reported and measured weight, height and body mass index (BMI) in Italy, the Netherlands and North America

Self-reported values of height and weight are used increasingly despite warnings that these data-and derived body mass index (BMI) values-might be biased. The present study investigates whether differences between self-reported and measured values are the same for populations from different regions, and the influences of gender and age. Differences between self-reported and measured weights, heights and resulting BMIs are compared for representative samples of the adult population of Italy, the Netherlands and North America. We observed that weight is under-reported (1.1 ± 2.6 kg for females and 0.4 ± 3.1 kg for males) and height over-reported (1.1 ± 2.2 cm for females and 1.7 ± 2.1 cm for males), in accordance with the literature. This leads to an overall underestimation of BMI values (0.7 ± 1.2 kg/m(2) or 2.8% for females and 0.6 ± 1.1 kg/m(2) or 2.3% for males). When BMI values are assigned to four categories (from 'underweight' to 'obesity'), 11.2% of the females and 12.0% of the males are categorized too low when self-reported weights and heights are used, with an extreme of 17.2% for Italian females. Older people tend to relatively over-report height and under-report weight, but the magnitude differs between countries and gender. We conclude that, apart from a general overestimation of height and underestimation of weight resulting in an underestimation of BMI, substantial differences are observed between countries, between females and males and between age groups.

Validity of Self-Reported Height, Weight, and Body Mass Index of the Korea Youth Risk Behavior Web-Based Survey Questionnaire

Self-reported anthropometric values, such as height and weight, are used to calculate body mass index (BMI) and assess the prevalence of obesity among adolescents. The aim of this study was to evaluate the validity of self-reported height, weight, and BMI of the Korea Youth Risk Behavior Web-based Survey questionnaire. A convenience sample of 137 middle school students and 242 high school students completed a self-administered questionnaire in 2008. Body height and weight were directly measured after self-reported values were obtained from the questionnaire survey. Sensitivity, specificity, and kappa statistics were computed in order to evaluate the validity of the prevalence of obesity (BMI ≥ 95th percentile or ≥ 25 kg/m(2)) based on self-reported data. Self-reported weight and BMI tended to be underestimated. Self-reported height tended to be overestimated among middle school females and high school males. Obese adolescents tended to underestimate their weight and BMI and overestimate their height more than non-obese adolescents. The prevalence estimate of obesity based on self-reported data (10.6%) was lower than that based on directly measured data (15.3%). The estimated sensitivity of obesity based on self-reported data was 69.0% and the specificity was 100.0%. The value of kappa was 0.79 (95% confidence interval, 0.70-0.88). This study demonstrated that self-reported height and weight may lead to the underestimation of BMI and consequently the prevalence of obesity. These biases should be taken into account when self-reported data are used for monitoring the prevalence and trends of obesity among adolescents nationwide.

Differences in Measured and Self-Reported Height and Weight in Dutch Adolescents

Background/Aims: Monitoring overweight prevalence and its trends in Dutch youth is frequently based on self-reported data. The validity of self-reported data especially in young adolescents is not sufficiently known. The purpose of this study is to study the validity of self-reported height and weight in 12- to 13-year-olds, to identify sociodemographic correlates and to explore whether correction factors can be developed to estimate the prevalence of overweight in youth. Methods: 5,525 12- to 13-year-old pupils in the Rotterdam area filled in a confidential questionnaire on health topics, including their height and weight. In a sub-sample of 499 pupils both self-reported and measured height and weight were available. Results: Self-reported data led to a considerable underestimation of Body Mass Index and consequently the prevalence of overweight. Underestimation was higher in pupils who regarded themselves as more fat, were of non-Dutch origin and in lower education levels. Conclusion: Self-reported height and weight appeared to be inappropriate to estimate the overweight prevalence in 12- to 13-year-olds, unless the figures were adjusted. Using adjusted self-reported BMI on an individual level is questionable. Actual measurements of height and weight are necessary to draw up valid correction formulas in new samples.

Underestimation of body mass index through perceived body image as compared to self-reported body mass index in the European Union

An observational, cross-sectional study was conducted in a representative sample of the European Union (7155 men and 8077 women) to calculate the underestimation of body weight as assessed by body image among the overweight and obese population and identify the associated factors to this behavior. Participants were older than 15 years and they were living in the 15 European Union countries. Body mass index (BMI) was grouped into 4 categories using the cutpoints established by the WHO, while perceived body image (PBI) was assessed using a nine-silhouettes drawing. The degree of underestimation between PBI as compared to BMI was identified in overweight and obesity categories of BMI. A multivariable logistic regression model for each gender was used to adjust for potentially confounding variables. Men classified themselves worse than women, being more likely to underestimate their body weight (65.2% of men underestimated their weight vs 32.2% women), regardless of other socioeconomic and attitudinal variables. The greatest degree of underestimation was observed in Mediterranean individuals (68.7% of men and 37.9% of women underestimated their weight). The subjects in the ‘maintenance’ stage of physical activity tended more often to wrongly select their actual image (71.8% for men and 38.7% for women). Public Health (2000) 114, 468–473.

Underestimation of body mass index through perceived body image as compared to self-reported body mass index in the European Union

An observational, cross-sectional study was conducted in a representative sample of the European Union (7155 men and 8077 women) to calculate the underestimation of body weight as assessed by body image among the overweight and obese population and identify the associated factors to this behavior. Participants were older than 15 years and they were living in the 15 European Union countries. Body mass index (BMI) was grouped into 4 categories using the cutpoints established by the WHO, while perceived body image (PBI) was assessed using a nine-silhouettes drawing. The degree of underestimation between PBI as compared to BMI was identified in overweight and obesity categories of BMI. A multivariable logistic regression model for each gender was used to adjust for potentially confounding variables. Men classified themselves worse than women, being more likely to underestimate their body weight (65.2% of men underestimated their weight vs 32.2% women), regardless of other socioeconomic and attitudinal variables. The greatest degree of underestimation was observed in Mediterranean individuals (68.7% of men and 37.9% of women underestimated their weight). The subjects in the ‘maintenance’ stage of physical activity tended more often to wrongly select their actual image (71.8% for men and 38.7% for women). Public Health (2000) 114, 468–473.