Skip to main content
SpringerLink
Log in

Accuracy of Body Mass Index Categories Based on Self-Reported Height and Weight Among Women in the United States

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

Objective The purpose of this study was to assess the accuracy of BMI categories based on self-reported height and weight in adult women. Methods BMI categories from self-reported responses were compared to categories measured during physical examination from women, age 18 or older, who participated in the National Health and Examination Survey, 1999–2004. We first examined strength of agreement using Cohen’s kappa, which, unlike sensitivity and specificity, allows for the comparison of polychotomous measures beyond chance agreement. Kappa regression identifies potential threats to accuracy. Likelihood of bias, as measured by under-reporting, was examined using logistic regression. Results Cohen’s kappa estimates were 0.443 for pregnant women (N = 724) and 0.705 for non-pregnant women (N = 5,910). Kappa varied by age and race, but was largely unrelated to socioeconomic status, health and health behaviors. Women who visited a physician in the last year or been diagnosed with osteoporosis were more accurate, while women most likely to under-report were older, white, non-Hispanic, and college-educated. Conclusions Our results suggest substantial agreement between self-reported and measured categories, except for women who are pregnant, above the age of 75 or without physician visits. Under-reporting may be more prevalent in well-educated, white populations than minority populations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. DHHS-CDC. (2006). State-specific prevalence of obesity among adults—Unites States, 2005. Morbidity and Mortality Weekly Report, pp. 985–1012.

  2. Kuczmarski, M. F., Kuczmarski, R. J., & Najjar, M. (2001). Effects of age on validity of self-reported height, weight, and body mass index: Findings from the Third National Health and Nutrition Examination Survey, 1988–1994. Journal of the American Dietetic Association, 101, 28–34. doi:10.1016/S0002-8223(01)00008-6.

    Article  PubMed  CAS  Google Scholar 

  3. Must, A., Spandano, J., Coakley, E., Field, A., Colditz, G., & Dietz, W. (1999). The disease burden associated with overweight and obesity. Journal of the American Dietetic Association, 282, 1523–1529.

    CAS  Google Scholar 

  4. Nieto-Garcia, F. J., Bush, T. L., & Keyl, P. M. (1990). Body mass definitions of obesity: Sensitivity and specificity using self-reported weight and height. Epidemiology (Cambridge, Mass), 1, 146–152. doi:10.1097/00001648-199003000-00011.

    CAS  Google Scholar 

  5. Schmidt, M. I., Duncan, B. B., Tavares, M., Polanczyk, C. A., Pellanda, L., & Zimmer, P. M. (1993). Validity of self-reported weight—a study of urban Brazilian adults. Revista de Saude Publica, 27, 271–276. doi:10.1590/S0034-89101993000400007.

    PubMed  CAS  Google Scholar 

  6. Bostrom, G., & Diderichsen, F. (1997). Socioeconomic differentials in misclassification of height, weight and body mass index based on questionnaire data. International Journal of Epidemiology, 26, 860–866. doi:10.1093/ije/26.4.860.

    Article  PubMed  CAS  Google Scholar 

  7. Brunner Huber, L. R. (2007). Validity of self-reported height and weight in women of reproductive age. Maternal and Child Health Journal, 11, 137–144. doi:10.1007/s10995-006-0157-0.

    Article  PubMed  Google Scholar 

  8. Spencer, E. A., Appleby, P. N., Davey, G. K., & Key, T. J. (2002). Validity of self-reported height and weight in 4808 EPIC-Oxford participants. Public Health Nutrition, 5, 561–565. doi:10.1079/PHN2001322.

    Article  PubMed  Google Scholar 

  9. Nyholm, M., Gullberg, B., Merlo, J., Lundqvist-Persson, C., Rastam, L., & Lindblad, U. (2007). The validity of obesity based on self-reported weight and height: Implications for population studies. Obesity (Silver Spring, Md.), 15, 197–208.

    Article  Google Scholar 

  10. Centers for Disease Control and Prevention NCfHSN. (1999–2004). National Health and Nutrition Examination Survey Data. Hyattsville, MD: US DHHS, Centers of Disease Control and Prevention.

  11. McDowell, M. A., Hughes, J. P., & Borrud, L. G. (2006). Health characteristics of U.S. adults by body mass index category: Results from NHANES 1999–2002. Public Health Report, 121, 67–73.

    Google Scholar 

  12. Landis, J. R., & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33, 159–174.

    Google Scholar 

  13. Lipsitz, A. R., Williamson, J., Klar, N., et al. (2001). A simple method for estimating a regression model for κ between a pair of raters. Journal of Royal Statistical Society Series A, 64(3), 449–465. doi:10.1111/1467-985X.00213.

    Google Scholar 

  14. Shoukri, M. M., & Mian, I. U. (1996). Maximum likelihood estimation of the kappa coefficient from bivariate logistic regression. Statistics in Medicine, 15, 1409–1419. doi:10.1002/(SICI)1097-0258(19960715)15:13≤1409::AID-SIM269≥3.0.CO;2-N.

    Article  PubMed  CAS  Google Scholar 

  15. Efron, B.T. & Tibshirani, R. J. (1993). An introduction to the bootstrap (Monographs on statistics and applied probability) (1st ed.). Chapman & Hall/CRC.

  16. Niedhammer, I., Bugel, I., Bonenfant, S., Goldberg, M., & Leclerc, A. (2000). Validity of self-reported weight and height in the French GAZEL cohort. International Journal of Obesity and Related Metabolic Disorders, 24, 1111–1118. doi:10.1038/sj.ijo.0801375.

    Article  PubMed  CAS  Google Scholar 

  17. Bolton-Smith, C., Woodward, M., Tunstall-Pedoe, H., & Morrison, C. (2000). Accuracy of the estimated prevalence of obesity from self reported height and weight in an adult Scottish population. Journal of Epidemiology and Community Health, 54, 143–148. doi:10.1136/jech.54.2.143.

    Article  PubMed  CAS  Google Scholar 

  18. Madrigal, H., Sanchez-Villegas, A., Martinez-Gonzalez, M. A., et al. (2000). Underestimation of body mass index through perceived body image as compared to self-reported body mass index in the European Union. Public Health, 114, 468–473. doi:10.1016/S0033-3506(00)00390-5.

    Article  PubMed  CAS  Google Scholar 

  19. Wada, K., Tamakoshi, K., Tsunekawa, T., et al. (2005). Validity of self-reported height and weight in a Japanese workplace population. International Journal of Obesity, 29, 1093–1099. doi:10.1038/sj.ijo.0803012.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

The authors thank the staff members, Mary Palmer, Kelly Muenzenberger, Angeline Vanto, and Kevin Benish, for their support of this project.

Author information

Authors and Affiliations

  1. Moffitt Cancer Center, 12902 Magnolia Drive, MRC-CANCONT, Tampa, FL, 33612-9416, USA

    Benjamin M. Craig

  2. Department of Family Medicine, University of Wisconsin-Madison, 777 South Mills Street, Room 3818, Madison, WI, 53715, USA

    Alexandra K. Adams

Authors
  1. Benjamin M. Craig
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alexandra K. Adams
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Benjamin M. Craig.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Craig, B.M., Adams, A.K. Accuracy of Body Mass Index Categories Based on Self-Reported Height and Weight Among Women in the United States. Matern Child Health J 13, 489–496 (2009). https://doi.org/10.1007/s10995-008-0384-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-008-0384-7

Keywords

Search

Navigation