Classification of the degree of obesity by body mass index or by deviation from ideal weight

Antonios H TZAMALOUKAS; Glen H MURATA; Richard M HOFFMAN; Darren W SCHMIDT; James E HILL; Annette LEGER; Linda MACDONALD; Carole CASWELL; Lesley JANIS; Robert E WHITE

doi:10.1177/0148607103027005340

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Classification of the degree of obesity by body mass index or by deviation from ideal weight

Journal article

Peer reviewed

Classification of the degree of obesity by body mass index or by deviation from ideal weight

Antonios H TZAMALOUKAS, Glen H MURATA, Richard M HOFFMAN, Darren W SCHMIDT, James E HILL, Annette LEGER, Linda MACDONALD, Carole CASWELL, Lesley JANIS and Robert E WHITE

JPEN. Journal of parenteral and enteral nutrition, Vol.27(5), pp.340-348

2003

DOI: 10.1177/0148607103027005340

PMID: 12971734

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Abstract

BACKGROUND: The purpose of this study was to compare classifications of subjects as underweight, normal weight, or obese by body mass index (BMI) and the ratio of body weight to ideal weight (W/IW). METHODS: We performed a theoretical comparison of the 2 indices. We compared classifications of the degree of obesity in 1839 women and 5914 men who were followed up in the primary care clinics of a United States federal hospital. Information was extracted from computerized records. Subjects were classified as underweight (BMI < 18.5 kg/m2, W/IW < 0.9), obese (BMI > or = 30.0 kg/m2, W/IW > or = 1.2), or normal weight (BMI, W/IW values between the cutoff values for underweight and obesity). W/IW values were computed assuming small, medium, and large skeletal frame for all. We compared the classifications of subjects as underweight, normal weight, or obese by BMI and W/IW. We used Cohen's kappa ratio to evaluate the agreement between these classifications. RESULTS: Theoretically, the cutoff values of BMI and W/IW for underweight and obesity are not in agreement. Patient data revealed substantial differences in the classifications of subjects as underweight, normal weight, or obese. Kappa ratios ranged between 0.18 (poor agreement) and 0.71 (reasonable, but not high degree of agreement). In general, kappa ratios were higher when assuming large or medium skeletal frame versus small frame. CONCLUSIONS: There are substantial discrepancies in classifying the subjects of a population as underweight, normal weight, or obese by BMI or W/IW. These discrepancies may cause confusion when 2 or more indices are used simultaneously to classify the degree of obesity.

Obesity

Biological and medical sciences

Metabolic diseases

Medical sciences

Details

Title: Subtitle: Classification of the degree of obesity by body mass index or by deviation from ideal weight
Creators: Antonios H TZAMALOUKAS - Renal Section, New Mexico Veterans Affairs Health Care System and University of New Mexico School of Medicine, Albuquerque, New Mexico, United States
Glen H MURATA - General Internal Medicine Section, New Mexico Veterans Affairs Health Care System and University of New Mexico School of Medicine, Albuquerque, New Mexico, United States
Richard M HOFFMAN - General Internal Medicine Section, New Mexico Veterans Affairs Health Care System and University of New Mexico School of Medicine, Albuquerque, New Mexico, United States
Darren W SCHMIDT - Medicine Service, New Mexico Veterans Affairs Health Care System and University of New Mexico School of Medicine, Albuquerque, New Mexico, United States
James E HILL - Clinical Section of Dietetics, New Mexico Veterans Affairs Health Care System, Albuquerque, New Mexico, United States
Annette LEGER - Clinical Section of Dietetics, New Mexico Veterans Affairs Health Care System, Albuquerque, New Mexico, United States
Linda MACDONALD - Renal Section, New Mexico Veterans Affairs Health Care System and University of New Mexico School of Medicine, Albuquerque, New Mexico, United States
Carole CASWELL - Clinical Section of Dietetics, New Mexico Veterans Affairs Health Care System, Albuquerque, New Mexico, United States
Lesley JANIS - General Internal Medicine Section, New Mexico Veterans Affairs Health Care System and University of New Mexico School of Medicine, Albuquerque, New Mexico, United States
Robert E WHITE - General Internal Medicine Section, New Mexico Veterans Affairs Health Care System and University of New Mexico School of Medicine, Albuquerque, New Mexico, United States
Resource Type: Journal article
Publication Details: JPEN. Journal of parenteral and enteral nutrition, Vol.27(5), pp.340-348
Publisher: ASPEN
DOI: 10.1177/0148607103027005340
PMID: 12971734
ISSN: 0148-6071
eISSN: 1941-2444
Language: English
Date published: 2003
Academic Unit: Epidemiology; General Internal Medicine; Internal Medicine
Record Identifier: 9984094603102771

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