Accuracy of self-reported weight: covariation with binger or restrainer status and eating disorder symptomatology

Validation of self-reported height and weight in fifth-grade Korean children

Height and weight are important indicators to calculate Body Mass Index (BMI); measuring height and weight directly is the most exact method to get this information. However, it is ineffective in terms of cost and time on large population samples. The aim of our study was to investigate the validity of self-reported height and weight data compared to our measured data in Korean children to predict obese status. Four hundred twenty-two fifth-grade (mean age 10.5 ± 0.5 years) children who had self-reported and measured height and weight data were final subjects for this study. Overweight/obese was defined as a BMI of or above the 85th percentile of the gender-specific BMI for age in the 2007 Korean National Growth Charts or a BMI of 25 or higher (underweight : < 5th, normal : ≥ 5th to < 85th, overweight : ≥ 85th to < 95th). The differences between self-reported and measured data were tested using paired t-test. Differences based on overweight/obese status were tested using analysis of variance (ANOVA) and linear trends. Pearson's correlation and Cohen's kappa were tested to examine agreements between the self-reported and measured data. Although measured and self-reported height, weight and BMI were significantly different and children tended to overreport their height and underreport their weight, the correlation between the two methods of height, weight and BMI were high (r = 0.956, 0.969, 0.932, respectively; all P < 0.001), and both genders reported their overweight/non-overweight status accurately (Cohen's kappa = 0.792, P < 0.001). Although there were differences between the self-reported and our measured methods, the self-reported weight and height was valid enough to classify overweight/obesity status correctly, especially in non-overweight/obese children. Due to bigger underestimation of weight and overestimation of height in obese children, however, we need to be aware that the self-reported anthropometric data were less accurate in overweight/obese children than in non-overweight/obese children.

Accuracy of self-reported weight and height and resulting body mass index among obese binge eaters in primary care: relationship with eating disorder and associated psychopathology

OBJECTIVE

This study assessed the accuracy of self-reported weight, height, and body mass index in obese patients with binge-eating disorder (DSM-IV-TR criteria) presenting at primary care clinics and tested whether the degree of inaccuracy was associated with demographic factors or eating disorder and depressive features.

METHOD

Sixty-six participants were interviewed using the Eating Disorder Examination interview, completed the Eating Disorder Examination Questionnaire and the Beck Depression Inventory, and had their height and weight measured between November 2007 and May 2009.

RESULTS

Self-reported and measured weight did not differ significantly, but participants significantly overestimated their height (P < .01), and this discrepancy resulted in a significantly lower self-reported than measured body mass index (P < .05). Discrepancy scores did not differ by eating disorder or depressive symptoms, sex, or ethnicity, although increasing age was associated with overestimation of height and underestimation of body mass index.

CONCLUSIONS

The findings suggest that obese patients with binge-eating disorder in primary care settings are reasonably accurate reporters of weight and height and that the degree of inaccuracy does not appear to be systematically related to eating disorder psychopathology or depressive features.

Objectified body consciousness in relation to recovery from an eating disorder

In Western society, the feminine body has been positioned as an object to be looked at and sexually gazed upon; thus, females often learn to view themselves as objects to be observed (i.e., objectified body consciousness (OBC)). This study examined the relation between OBC and eating disorder recovery by comparing its components across non-eating disorder controls, fully recovered, partially recovered, and active eating disorder cases. Results revealed that non-eating disorder controls and fully recovered individuals had similarly low levels of two components of OBC, body surveillance and body shame. Partially recovered individuals looked more similar to those with an active eating disorder on these constructs. The third component of OBC, control beliefs, and a conceptually similar construct, weight/shape self-efficacy, did not differ across groups. Results provide support for the importance of measuring aspects of self-objectification, particularly body surveillance and body shame, across the course of an eating disorder.

The acquired preparedness model of risk for bulimic symptom development

The authors applied person-environment transaction theory to test the acquired preparedness model of eating disorder risk. The model holds that (a) middle-school girls high in the trait of ineffectiveness are differentially prepared to acquire high-risk expectancies for reinforcement from dieting or thinness; (b) those expectancies predict subsequent binge eating and purging; and (c) the influence of the disposition of ineffectiveness on binge eating and purging is mediated by dieting or thinness expectancies. In a three-wave longitudinal study of 394 middle-school girls, the authors found support for the model. Seventh-grade girls' scores on ineffectiveness predicted their subsequent endorsement of high-risk dieting or thinness expectancies, which in turn predicted subsequent increases in binge eating and purging. Statistical tests of mediation supported the hypothesis that the prospective relation between ineffectiveness and binge eating was mediated by dieting or thinness expectancies, as was the prospective relation between ineffectiveness and purging. This application of a basic science theory to eating disorder risk appears fruitful, and the findings suggest the importance of early interventions that address both disposition and learning.

Accuracy of self-reported weight and height: relationship with eating psychopathology among young women

OBJECTIVE

Self-reported height and weight data are commonly reported within eating disorders research. The aims of this study are to demonstrate the accuracy of self-reported height and weight and to determine whether that accuracy is associated with levels of eating psychopathology among a group of young nonclinical women.

METHOD

One hundred and four women were asked to report their own height and weight. They then completed the Eating Disorders Examination-Questionnaire. Finally, they were weighed and their height was measured in a standardized manner. Accuracy scores for height and weight were calculated by subtracting their actual weight and height from their self-reports.

RESULTS

Overall, the women overestimated their heights and underestimated their weights, leading to significant errors in body mass index where self-report is used. Those women with high eating concerns were likely to overestimate their weight, whereas those with high weight concerns were more likely to underestimate it.

DISCUSSION

These data show that self-reports of height and weight are inaccurate in a way that skews any research that depends on them. The errors are influenced by eating psychopathology. These findings highlight the importance of obtaining objective height and weight data, particularly when comparing those data with those of patients with eating disorders.

The prevalence of abnormal eating behaviour in a representative sample of the French diabetic population

AIM

To assess the relationship between abnormal eating behaviour (AEB) and diabetes in a sample of French adult patients with type 1 (T1D) and type 2 (T2D) diabetes.

METHODS

Ninety-four consecutively recruited patients self-completed a series of validated questionnaires.

RESULTS

Over one-fourth of men with T1D (26%) or T2D (27%) and 11% of female T2D patients reported consistent and pathological overeating or binge-eating during the previous six months. Glycaemic control in these T1D patients was poorer than in T1D patients defined as normal eaters (NORM) (11.9% versus 9.6%), but did not reach statistical significance (P=0.08), and no significant difference was observed in the T2D group (P=0.61) either. T2D patients reported being markedly more restrained when eating than did the T1D patients (P=0.002), and their restraint increased along with their BMI (P<0.001). Patients who overate or binged also reported greater general hunger (P=0.02) and disinhibition (P=0.003) than did the NORM patients.

CONCLUSION

AEB is present in French diabetic patients at levels that are probably higher than among the general population. These results highlight the need for: (1) greater awareness among diabetes clinicians of the problem; (2) regular screening of diabetic patients for AEB; and (3) adaptation of therapeutic and dietary recommendations for this patient subgroup.

Aggressiveness, anger, and hostility in eating disorders

OBJECTIVE

Despite evidence of a link between the behavioral and cognitive dimensions of aggressiveness and eating disorders, only few studies have tested this relation empirically.

METHODS

A total of 112 female patients with anorexia nervosa (n = 61) or bulimia nervosa (n = 51) and 631 young girls attending 7 high schools in the same health district as the patients (northeast Italy) were invited to fill in a set of self-report instruments including the Eating Attitudes Test, the Bulimic Investigatory Test of Edinburgh, the Body Attitudes Test, and the Buss-Perry Aggression Questionnaire (AQ).

RESULTS

In both healthy controls and patients, scores on the measures of eating disorder symptoms were positively related to the scores on the AQ: the strength of the association did not differ between healthy controls and patients. However, patients diagnosed with eating disorders were not more likely to disclose a propensity to aggression than the healthy controls drawn from the community: patients with anorexia nervosa scored lower than controls on the physical aggression and on the verbal aggression subscales of the AQ (P < .05). On the other hand, patients with bulimia nervosa scored higher than controls on the anger subscale of the AQ (P < .05) but did not differ from them on the other subscales of the questionnaire.

CONCLUSIONS

The results confirm the higher propensity to anger in patients with bulimia nervosa; in patients with anorexia nervosa, difficulties in expressing anger and outward-directed aggressiveness can be a prevailing feature. The younger age of controls and exclusive reliance on self-report measures might have concealed some differences between patients and community subjects.

A comparison of direct vs. self-report measures for assessing height, weight and body mass index: a systematic review

Obesity is a rapidly increasing public health problem, with surveillance most often based on self-reported values of height and weight. We conducted a systematic review to determine what empirical evidence exists regarding the agreement between objective (measured) and subjective (reported) measures in assessing height, weight and body mass index (BMI). Five electronic databases were searched to identify observational and experimental studies on adult populations over the age of 18. Searching identified 64 citations that met the eligibility criteria and examined the relationship between self-reported and directly measured height or weight. Overall, the data show trends of under-reporting for weight and BMI and over-reporting for height, although the degree of the trend varies for men and women and the characteristics of the population being examined. Standard deviations were large indicating that there is a great deal of individual variability in reporting of results. Combining the results quantitatively was not possible because of the poor reporting of outcomes of interest. Accurate estimation of these variables is important as data from population studies such as those included in this review are often used to generate regional and national estimates of overweight and obesity and are in turn used by decision makers to allocate resources and set priorities in health.

Rural/urban differences in the distribution of eating disorder symptoms among adolescents from community samples

OBJECTIVE

Rural/urban differences in the prevalence of mental disorders have often been reported in the last 30 years, among others in the distribution of eating disorder symptoms and suicide rates. The role of sex, age and socioeconomic status in the differences by place of residence has often been neglected in past studies.

METHOD

Two independent community samples of students (mean age=17.4 years, SD=1.4), taken from among those attending high school in an urban district (Cagliari; n=817) and in a rural one (Carbonia; n=507) of south Sardinia, Italy, were invited to fill in the Eating Attitudes Test (EAT), the Bulimic Investigatory Test of Edinburgh (BITE), the Body Attitudes Test (BAT) and the revised Hopkins Symptom checklist (SCL-90-R).

RESULTS

Female students scored higher than male students on all inventories. In male participants, the scores on the EAT were higher in the urban than in the rural sample. Conversely, in both male and female students the rural sample reported higher scores on the BITE symptoms subscale. When the comparison was confined to the fraction of those who scored higher than the suggested cut-off on the EAT and the BITE, students in the urban sample outnumbered those in the rural sample. No other differences were found. Socioeconomic status and age did not influence the differences in the reporting of eating disorder symptoms by place of residence.

CONCLUSIONS

Although caution is required when reading the findings drawn from self-report instruments, it is evident that the factors influencing the distribution of eating disorder symptoms and their psychological correlates by place of residence are far more complex than currently thought.

Several anthropometric measurements and breast cancer risk: results of the E3N cohort study

OBJECTIVE

To investigate the association between various anthropometric characteristics and breast cancer.

DESIGN

Longitudinal prospective cohort study. Follow-up between 1995 and 2000.

SUBJECTS

In total, 69 116 women (age: 45-70 years; mean follow-up: 3.6 years), 275 premenopausal and 860 postmenopausal incident invasive breast cancers.

MEASUREMENTS

Self-reported height, weight, breast, thorax, waist and hip circumferences and calculated body mass index (BMI) and waist-to-hip ratio (WHR) at baseline.

RESULTS

A slight increase in risk with increasing height was found. Weight, BMI, thorax and waist circumferences and WHR were negatively related to breast cancer risk among premenopausal women. The relationships became non significant after additional adjustment for BMI. An increased risk of premenopausal breast cancer with an android body shape (WHR>0.87) might possibly be confined to obese women. Among postmenopausal women, all anthropometric measurements of corpulence were positively associated with breast cancer risk but became non significant after additional adjustment for BMI. No difference in risk of postmenopausal breast cancer according to HRT use was observed.

CONCLUSION

The study confirmed that adiposity was negatively associated to premenopausal breast cancer risk and positively associated to postmenopausal breast cancer risk. Further studies will be needed to specify clearly the association between WHR and breast cancer risk, particularly before menopause.

Accuracy of reported weight and menstrual status in teenage girls with eating disorders

OBJECTIVE

The current study investigated the accuracy of reported current and historical weights and of menstrual status in teenage girls with eating disorders.

METHOD

Reported current weight in one interview was compared with measured weight at another occasion. Reported historical weights were compared with documented weights from growth charts of the school health services. Reports of menstrual status from two different interviews were compared.

RESULTS

The overall correlation between reported and measured/documented weight was high. Current weight was reported with high accuracy in all diagnostic groups and without tendencies to underreport. Patients with bulimia nervosa, but not those with anorexia nervosa, underreported their historical top weight. The most common reason for large discrepancies between reported and documented historical weights was that the two weights compared referred to different time points. The reports on menstrual status were divergent for 13% of the patients, most notably 4 of 15 patients on oral contraceptives had been categorized as having menstruations in one of the interviews.

CONCLUSION

Reported weight history and menstrual status are of high accuracy in teenage girls with eating disorders.

Anthropometry, breast cancer and menopausal status: Use of repeated measurements over 10 years of follow-up?results of the French E3N women's cohort study

The association between weight, BMI and breast cancer was analyzed on 94,805 women of the E3N cohort according to their menopausal status. Seven hundred eighty-six incident invasive premenopausal breast cancers and 1,522 incident invasive postmenopausal breast cancers occurred during a mean follow-up of 9.7 years. Weight and BMI were updated every 24 months and considered as time-dependent variables. Data were analyzed using multivariate Cox proportional hazards models. Trend RRs of premenopausal breast cancer were 0.97 (0.92-1.01) for a 5 kg increase in weight and 0.96 (0.91-1.01) for a 2 kg/m(2) increase in BMI, adjusted for other known risk factors. Opposite trend RRs were found after menopause: 1.05 (1.02-1.08) for weight and 1.06 (1.02-1.09) for BMI, respectively, for similar increases. Women with a BMI of over 30 kg/m(2) had a RR of premenopausal breast cancer of 0.66 (0.40-1.10) compared to those with a BMI of between 18.5 and 25 kg/m(2). Postmenopausal women with a BMI of over 30 kg/m(2) had a RR of breast cancer of 1.23 (1.00-1.59). The increase in risk of postmenopausal breast cancer with increased weight or BMI was similar whatever the HRT used, although the point estimates were higher in HRT users. We strongly recommend to use anthropometric measurements updated during follow-up to assess the effect of weight, BMI on breast cancer risk.

Media Effects on Expectancies: Exposure to Realistic Female Images as a Protective Factor

Although frequent exposure to very thin female models is likely the norm for American women, exposure to attractive, average-weight models is likely unusual and may therefore be influential. The authors hypothesized that women at risk for eating disorders who are exposed to attractive, average-weight models would endorse fewer expectancies for reinforcement from thinness than would other women. The hypothesis was confirmed: High-risk women exposed to average-weight model images were less likely to endorse thinness/restricting expectancies than those who were exposed to thin models or to control images. Media exposure to realistic female images appears to lessen the relationship between at-risk status and subsequent endorsement of thinness/restricting expectancies and may therefore disrupt the risk process.

Dietary restraint and the mis-reporting of anthropometric measures by middle-aged adults

OBJECTIVE

To assess whether levels of dietary restraint are associated with mis-reporting measures of adiposity by middle-aged adults.

DESIGN

Cross-sectional study of middle-aged men and women, the parents of a group of young adults followed up since birth.

METHODS

In all, 631 couples were mailed questionnaires and asked to record their height, weight and waist circumference. A paper tape measure with instructions for use was attached. Couples also completed the dietary restraint section of the Dutch Eating Behaviour Questionnaire, and provided information on employment and lifestyle habits. A subsample of participants was then invited to attend a clinic where detailed anthropometric measures were taken.

RESULTS

In all, 435 women (69%) and 332 men (55%) completed the questionnaire; of those invited, 182 (85%) women and 102 (61%) men attended a clinic session. Regression analyses showed that the dietary restraint score was associated with the mis-reporting of BMI by women (P<0.01), but not men (test for interaction with gender, P=0.11). In women, the difference between the measured and reported BMI increased by 0.36 kg/m(2) (0.11-0.61) per unit increase in restraint score. This association was independent of age, smoking, social class, slimming, exercise frequency or television viewing time, but was attenuated in models controlling for measured BMI. The dietary restraint score was not associated with mis-reporting of waist circumference in men or women.

CONCLUSIONS

Dietary restraint score may be a useful tool for identifying individuals more likely to mis-report anthropometric measurements, although associations may vary by gender.

Accuracy of self-reported height and weight in women: an integrative review of the literature

Height and weight are two of the most commonly used anthropometric measurements in clinical practice and research. Self-reported height and weight measurement is a simple, efficient, inexpensive, and non-invasive method of collecting data from large numbers of people. This integrative review of the published research examined the accuracy of self-reported height and weight measurements in women. Twenty-six studies examined the accuracy of self-reported height in 39,244 women. Twenty-one of the studies found that women overestimate height. Thirty-four studies reviewed the accuracy of self-reported weight in 57,172 women, and all 34 studies reported that women underestimated weight. Although mean variations between self-reported and measured values were small, a significant percentage of women in study groups had very large errors. Inaccurate measurements of both height and weight can cause significant inaccuracies in calculation of body mass index, which is used as a guide for identifying persons at risk for disease. These findings indicate that direct measurement of height and weight should be performed whenever possible for optimal measurements in clinical practice and clinically oriented research.

Anthropometric measurements and body silhouette of women: validity and perception

OBJECTIVE

To examine the validity of self-reported values for current anthropometric measurements and factors related to misreporting.

DESIGN

E3N, a prospective cohort study of cancer risk factors, conducted in France and part of the European Prospective Investigation on Cancer. E3N comprises 100,000 women, born between 1925 and 1950, followed with self-administered questionnaires sent every 18 to 24 months starting in 1990.

SUBJECTS

152 women for the validation study of self-reported anthropometric measurements, and 91,815 women selected to evaluate factors affecting misreporting of body silhouette.

STATISTICAL ANALYSIS

Paired t tests, Pearson and Spearman correlations were applied to evaluate the validity of self-reported measures, and analysis of variance and logistic regression were used to assess the factors influencing misreporting of silhouette.

RESULTS

The correlation coefficients between self- and external measurements were high. All but sitting height (r = 0.56) were more than 0.80, with weight and bust (nipples) measurement correlation coefficients attaining 0.94. The correlation between body mass index (BMI), measured by the technician and the self-reported silhouette, was 0.78. Small height was always associated with misclassification. Specific factors related to a more favorable perception of body silhouette were: being overweight, small height, younger age, and a lower level of education. These women were also more frequently unmarried, more physically active, and had had a slender body shape during adolescence. Results denoting a less favorable perception of body shape were reversed. CONCLUSION/APPLICATIONS: Self-reported measurements (made with or without help) are valid measures in epidemiological studies. Body silhouettes are simple and useful indicators of body mass index. However they should be interpreted with caution in certain instances, especially for overweight subjects.

Eating behavior correlates of adult weight gain and obesity in healthy women aged 55-65 y

BACKGROUND

The specific underlying causes of adult weight gain remain uncertain.

OBJECTIVE

The objective was to determine the association of 3 measures of eating behavior with weight gain and body mass index (BMI; in kg/m(2)) in adults.

DESIGN

Current dietary restraint, disinhibition, and hunger were assessed with the use of the Eating Inventory in 638 healthy, nonsmoking women aged 55-65 y. In addition, subjects reported their current weight and height, their weight for 6 age intervals, and changes in voluntary dietary energy restriction over the past 10 y. Current weight and height were validated in 10% of subjects.

RESULTS

Current disinhibition strongly predicted weight gain and current BMI (partial r = 0.27 and 0.34, respectively, both P < 0.001). Neither restraint nor hunger was a significant independent predictor of either variable, but the positive associations between disinhibition and both weight gain and BMI were attenuated by restraint (P = 0.016 and 0.010, respectively, after adjustment for confounding variables). In the subpopulation of women who reported a stable level of voluntary dietary energy restriction, disinhibition also strongly predicted weight gain and higher BMI, and restraint was negatively associated with weight gain (partial r = -0.17, P = 0.019).

CONCLUSIONS

Higher disinhibition is strongly associated with greater adult weight gain and higher current BMI, and dietary restraint may attenuate this association when disinhibition is high. These findings suggest that eating behavior has an important role in the prevention of adult-onset obesity and that further studies are warranted.

The eating attitudes test: twenty-five years later

This manuscript reviews the literature involved with the Eating Attitudes Test (EAT), first developed in the late 1970s as a self-report, indicative of the symptoms of eating disorders. The EAT has good psychometric properties of reliability and validity, and reasonable sensitivity and specificity for the eating disorders, but very low positive predictive value because eating disorders are relatively uncommon. In addition they exist on a continuum, because of denial and social desirability, the results of a self-report instrument may be affected. A very large literature has documented the use of the EAT in a variety of cultures. It is used to screen eating disturbances in general as the first part of a two-part diagnostic screen, as an ability to compare across groups and to measure change between groups and over time.

Accuracy of self-reported weight in patients with binge eating disorder

OBJECTIVE

This study was designed to evaluate the accuracy of self-reported weight in patients with binge eating disorder.

METHOD

Subjects were 108 adults who were consecutively evaluated for outpatient clinical trials and met DSM-IV criteria for binge eating disorder. Self-reported and measured weights were taken and participants were administered a battery of measures to examine correlates of reporting error. In addition, accurate reporters of weight (i.e., individuals who reported their weight within 5 lb of their measured weight) were compared to underreporters (i.e., individuals who underreported their weight by more than 5 lb) on eating disorder psychopathology and conceptually related measures.

RESULTS

Overall, most binge eating disorder subjects were accurate in reporting weight: 73% were accurate within 5 lb and 82% were accurate within 10 lb. Self-reported and measured body mass index were highly correlated and the magnitude of the difference was nonsignificant. Body mass index was not significantly associated with the degree of accuracy, that is, accurate reporters weighed about the same as underreporters. Accurate reporters and underreporters did not differ on measures of overeating behaviors, eating disorder psychopathology, and conceptually related measures.

DISCUSSION

These findings suggest that most patients with binge eating disorder were accurate in self-reporting weight. Unlike findings in healthy samples, heavier patients with binge eating disorder were not more likely to underreport weight. Similar to findings in patients with bulimia nervosa, eating disorder psychopathology was not related to reporting error.

Use of the BULIT bulimia screening questionnaire to assess risk and progress in weight management for overweight women who weight cycle. BULImia Test

A bulimia screening questionnaire was examined for usefulness in assessing risk for bulimia and measuring progress in reducing binge eating in overweight women who weight cycle. In two studies the BULIT test was used to screen for risk for bulimia. Study 1 was a descriptive study of motivations for overeating in normal weight women compared to overweight women who weight cycled. In Study 2, overweight women who weight cycled were examined at baseline, 6, and 12 months for effectiveness of a clinical treatment strategy to reduce binge eating. In Study 1, BULIT scores were statistically significantly higher for overweight compared to normal weight subjects. In Study 2, subjects' BULIT scores were lower after using a long term clinical treatment strategy to gain control of eating. The BULIT test was useful for specifying four categories of eating patterns to assess risk for bulimia and progress in reducing binge eating.

The role of weight concern and self-efficacy in smoking cessation and weight gain among smokers in a clinic-based cessation program

Although the majority of smokers are concerned about postcessation weight gain, few studies have investigated the prospective relationship between weight concern and smoking and weight outcomes, or a mechanism by which concern is related to these outcomes. We investigated the prospective role of smoking-specific weight concern in smoking cessation and weight gain among participants in a smoking-cessation clinic, and we hypothesized that domain-specific self-efficacy would be a mediator of these relationships. While weight concern did not prospectively predict smoking status, increased weight concern predicted weight gain at the end of treatment and at 3-month follow-up. Self-efficacy for preventing postcessation weight gain mediated this relationship; lower levels were related to a greater likelihood of weight gain. Weight gain was found to be associated with subsequent relapse among abstainers. Implications and treatment recommendations are discussed.

Characteristics of the low-energy reporters in a longitudinal national dietary survey

The aim of the present study was to establish whether the characteristics of members of a large national birth cohort study who submitted diet diaries with implausibly low-energy intake differed from those whose recorded energy intake was more plausible. Survey members (n 1898) recorded their diets in a 7 d diary in household measures. Those whose reported energy intake (EI) as a fraction of their estimated BMR was less than 1.10, here termed low-energy reporters (LER) but often called under-reporters, constituted 20.6% of the study population. None of the variables describing dietary, smoking or exercise behaviour bore a significant relationship with low EI/BMR (< 1.10), neither did those describing region of residence, subjective adequacy of income, current social class, social relations or the social environment of the subjects. Results of logistic regression analysis showed that the only independently significant characteristic for men was higher BMI. In women, in addition to higher BMI, having been overweight or obese as an adult independently, but less significantly, predicted low EI/BMR, while membership as a child of social class III (non-manual), having more children in the household and having a paid job marginally but independently decreased the probability of reporting low EI/BMR. Submission of a diary with EI/BMR < 1.10 7 years earlier in the same survey was an even more powerful predictor of current low EI/BMR than higher BMI in both sexes. The average reported diet-composition of LER was more micronutrient- and protein-rich than that of the others, indicating different dietary, or diet-recording, behaviour in this group of subjects. LER are not a random sample of the survey population, and their characteristics, definable to some extent, put them at risk for lower health status. Although EI/BMR cut-off points can be used to identify LER, the problem of how to use their data is still unresolved.

A new visual image rating scale for females: correlations with measures of relative fatness, weight dissatisfaction, and body-esteem

A new Visual Image Rating Scale for females was developed from a computer-reconstructed photograph to produce figures with realistic three-dimensional contour and different types of fat and muscle distribution. Correlations between choice of figures selected by a group of college women on two occasions two weeks apart gave significant test-retest stability. To estimate the construct validity of the scale in assessing body satisfaction, at the time the scale was first administered 77 undergraduate women were asked to select the figure closest to their current physique and to complete the Body-esteem Scale. Figure selection was highly correlated with relative fatness as measured by Body Mass Index and with scores on the Weight Concern subscale of the Body-esteem Scale. The utility of the scale for women of color or for women of a wider range of age and socioeconomic status remains to be evaluated.

Longitudinal follow-up of amenorrhea in eating disorders

The authors recruited 229 treatment-seeking anorexic and bulimic women for a prospective, longitudinal study. Telephone interviews were arranged every 3 months for at least 1 year for 225 patients. At intake, 132 subjects were menstruating, 34 subjects were taking oral contraceptives, 5 subjects had an organic cause for amenorrhea (e.g., hysterectomy), and 58 subjects were amenorrheic. Each patient met Diagnostic and Statistical Manual of Mental Disorders, third edition, revised (DSM-III-R) criteria for anorexia nervosa (AN, N = 41), bulimia nervosa (BN, N = 98), or AN/BN (N = 90). All subjects were interviewed with the Schedule for Affective Disorders and Schizophrenia-Lifetime Version, which was modified to include a section for DSM-III-R eating disorders, the Longitudinal Interval Follow-Up Evaluation, and the Structured Interview for DSM-III Personality Disorders. It was found that body weight was associated with menstrual status: those with amenorrhea had a mean percent ideal body weight (IBW, Metropolitan Life criteria) of 74 +/- 1% compared with 102 +/- 19% for menstruating patients (p < .01). Affective illness was more prevalent among patients with amenorrhea than among menstruating patients (75% vs. 56%, p < .05). Menses were regained within 1 year by 33% of amenorrheic patients. These patients gained an average of 7.3% of their IBW. Longer duration of eating disorder (p < .03) and the presence of an anxiety disorder (p < .05) were associated with persistent amenorrhea. Menses were lost within 1 year by 8% of menstruating patients. These patients lost an average of 5.0% of their IBW.(ABSTRACT TRUNCATED AT 250 WORDS)

Validity of physicians' self-reports of cardiovascular disease risk factors

To determine the accuracy of self-reported risk factors in 78 physicians, self-reported information was compared to findings on a standardized examination. Measured weight (r = 0.98), height (r = 0.95), body mass index (r = 0.96), systolic blood pressure (SBP) (r = 0.72), and diastolic blood pressure (DBP) (r = 0.60) were highly correlated with self-reported values (all P < 0.0001). Mean self-reported SBP and DBP did not differ from measured values; measured weight was 1.5 kg greater and measured height 1.4 cm less than self-reported values (both p < 0.0001). Regression of measured on self-reported values indicated excellent agreement except for DBP and heart rate. Differences between measured and self-reported values were not associated with a variety of variables except for a greater difference in SBP at higher levels of SBP. None of the 60 self-reported nonsmokers had expired carbon monoxide levels greater than 10 ppm. These results indicate that physicians' self-reports of height, body mass index, SBP, and smoking are extremely accurate and suitable for research purposes.