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The scale matters: assessing body size with figure rating scales in a diverse sample of young adults

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Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity Aims and scope Submit manuscript

Abstract

Purpose

To explore intersectional differences in weight perception accuracy in a diverse sample of young adults using CDC-defined weight status labels and four separate figure rating scales (FRS).

Methods

This cross-sectional study of 322 18–25-year-olds with body mass index (BMI) ranging from 18.5 to 57.2 (MBMI = 26.01, SD = 6.46) enrolled participants as part of a larger university subject pool cohort in the U.S. MidSouth. Height and weight measurements were obtained. Participants (55% Black, 45% white; 74% female) selected images that best represented their current body size using four FRS and described their weight perception using five labels from “very underweight” to “very overweight/obese”. Receiver operating characteristic (ROC) curve analyses were used to compare variability in classification of weight status by FRS and weight perception category across gender and race.

Results

Area under the curve (AUC) statistics indicated all scales were significantly better at classifying weight status than chance. Among Black females and Black males, the culturally adapted scale had the strongest discriminatory ability [(AUC = 0.93, SE = 0.02, p < 0.001, 95% CI = 0.89–0.97) and (AUC = 0.93, SE = 0.04, p < 0.001, 95% CI = 0.86–1.00), respectively]. Among white females, the silhouette scale had the strongest discriminatory ability (AUC = 0.93, SE = .03, p < 0.001, 95% CI = 0.88–0.99). Among white males, the photo-based scale had the strongest discriminatory ability (AUC = 0.84, SE = 0.06, p = 0.001, 95% CI = 0.71–0.96). Across all groups, weight perception labels were the weakest classifier of weight status.

Conclusion

Weight perception labels are an ineffective method of assessing weight status and FRS accuracy varies by race and gender, suggesting the value of gender- and culturally tailored scales.

Level of evidence

Level III. Evidence obtained from well-designed cohort or case-control analytic studies.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Code availability

Not applicable.

Notes

  1. Race is a political and social construct that often serves as a proxy for the impact of racist practices and structural inequality, it is not a biological variable and thus is examined in the paper with this premise in mind (for additional review see [9, 10]). We have chosen to capitalize Black to indicate the shared culture and history of Black and African American people in the United States and to raise awareness about the marginalization of Black identity.

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Acknowledgements

We would like to thank Mollie Anderson, Robin Hardin, and Jamie Padden, for their assistance with data collection for this project. We would also like to thank the young adults at the University of Memphis who participated in this study.

Funding

The authors did not receive any funding for conducting this study.

Author information

Authors and Affiliations

  1. Department of Psychological and Brain Sciences, Texas A&M University, 256 Psychology Bldg, 4235 TAMU, College Station, TX, 77843, USA

    Idia B. Thurston & Caitlyn E. Maye

  2. Department of Health Promotion and Community Health Sciences, Texas A&M Health, College Station, USA

    Idia B. Thurston

  3. Department of Pediatrics, University of Tennessee Health Science Center, Memphis, USA

    Idia B. Thurston

  4. Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital, Cincinnati, USA

    Kristina M. Decker

  5. Yale Child Study Center, Yale University School of Medicine, New Haven, USA

    Rebecca C. Kamody

  6. Department of Psychology, University of Memphis, Memphis, USA

    Caroline C. Kaufman

  7. Department of Adolescent and Young Adult Medicine, Boston Children’s Hospital/Harvard Medical School, Boston, USA

    Tracy K. Richmond

  8. Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, USA

    Kendrin R. Sonneville

Authors
  1. Idia B. Thurston
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  2. Kristina M. Decker
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  3. Rebecca C. Kamody
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  6. Tracy K. Richmond
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  7. Kendrin R. Sonneville
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Corresponding author

Correspondence to Idia B. Thurston.

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The authors have no conflicts of interest to declare that are relevant to the content of this article.

Ethics approval

The questionnaire and methodology for this study was approved by the Human Research Ethics committee of the University of Memphis (IRB#: 3070).

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Informed consent was obtained from all individual participants included in the study.

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Thurston, I.B., Decker, K.M., Kamody, R.C. et al. The scale matters: assessing body size with figure rating scales in a diverse sample of young adults. Eat Weight Disord 27, 263–271 (2022). https://doi.org/10.1007/s40519-021-01166-9

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  • DOI: https://doi.org/10.1007/s40519-021-01166-9

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