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Measuring obesity in the absence of a gold standard

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  • O’Neill, Donal

Abstract

Reliable measures of body composition are essential to develop effective policies to tackle obesity. The lack of an acceptable gold-standard for measuring fatness has made it difficult to evaluate alternative measures of obesity. We use latent class analysis to characterise existing diagnostics. Using data on US adults we show that measures based on body mass index and bioelectrical impedance analysis misclassify large numbers of individuals. For example, 45% of obese White women are misclassified as non-obese using body mass index, while over 50% of non-obese White women are misclassified as being obese using bioelectrical impedance analysis. In contrast the misclassification rates are low when waist circumference is used to measure obesity. These results have important implications for our understanding of differences in obesity rates across time and groups, as well as posing challenges for the econometric analysis of obesity.

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  • O’Neill, Donal, 2015. "Measuring obesity in the absence of a gold standard," Economics & Human Biology, Elsevier, vol. 17(C), pages 116-128.
    • Handle: RePEc:eee:ehbiol:v:17:y:2015:i:c:p:116-128
    DOI: 10.1016/j.ehb.2015.02.002
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    1. Davillas, Apostolos & Benzeval, Michaela, 2016. "Alternative measures to BMI: Exploring income-related inequalities in adiposity in Great Britain," Social Science & Medicine, Elsevier, vol. 166(C), pages 223-232.

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    More about this item

    Keywords

    Obesity; Multiple diagnostic tests; Latent class analysis;
    All these keywords.

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • C38 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Classification Methdos; Cluster Analysis; Principal Components; Factor Analysis

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