O'Neill, Donal
(2015)
Measuring obesity in the absence of a gold standard.
Economics and Human Biology, 17.
pp. 116-128.
ISSN 1570-677X
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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