Introduction and Objective: Body mass index (BMI), weight adjusted for height, is an imprecise tool for the diagnosis of obesity. Body composition assessment with bioelectric impedance analysis (BIA) scales estimate fat mass and % adiposity, offering a more precise diagnosis of obesity. The objective of this project was to compare the use of BMI and BIA scale assessment of % adiposity for the diagnosis of obesity.Methods: Obesity status was determined by both traditional BMI and BIA scale in our weight management clinic. BMI (kg/m2) was calculated from weight and height measured by stadiometer. Body composition was assessed with TANITA BIA scale MC-780U. Body composition measures included total body water, fat, muscle and bone mass, and % adiposity. BMI classification of obesity was as follows: obese BMI ≥ 30 kg/m2, overweight BMI 25 – 29.9 kg/m2, normal BMI 18.6 – 24.9 kg/m2. Classification of obesity by BIA % adiposity was: women ≥ 33%, men >25%. Concordance between BMI and BIA assessments for the diagnosis of obesity was analyzed.Results: Of 112 patients assessed, 87% were female, 49% non-Hispanic white, 43% black. Mean age was 49±13 years, BMI 36.4±7.7 kg/m2, and % adiposity 40.3±8.2%. BMI classification diagnosed 81.2% (n=91) with obesity, 12.5% (n=14) overweight, and 6.2% (n=7) normal. BIA % adiposity score diagnosed 83.9% (n=94) with obesity. The diagnosis of obesity was concordant between BMI and BIA classification in 87.5% (n=98). Of 14 discordant cases, 86% (n=12) were female; 64% were middle age 39-59 years. Eight were classified as obese by BIA but not BMI. Six were classified as obese by BMI but not BIA.Conclusion: Assessment of adiposity by BIA scale offers an accurate measure of total and percent adiposity that more precisely classifies patients as obese than traditional BMI measures calculated from height and weight alone. Discordance between the two different measures raises concern for misclassification of obesity status which may over or underestimate related health risks.
A. Johnson-Jennings: None. A.D. Coviello: Advisory Panel; Novo Nordisk. Consultant; Intuitive Surgical. Other Relationship; GI Dynamics. Consultant; Hanmi Pharm. Co., Ltd. Advisory Panel; NewAmsterdam Pharma.
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