title: Comparing apples and pears: women's perceptions of their body size and shape.
abstract: BACKGROUND
  Obesity is a growing public health problem among reproductive-aged women, with consequences for chronic disease risk and reproductive and obstetric morbidities. Evidence also suggests that body shape (i.e., regional fat distribution) may be independently associated with risk, yet it is not known if women adequately perceive their shape. This study aimed to assess the validity of self-reported body size and shape figure drawings when compared to anthropometric measures among reproductive-aged women.
  
  
  METHODS
  Self-reported body size was ascertained using the Stunkard nine-level figures and self-reported body shape using stylized pear, hourglass, rectangle, and apple figures. Anthropometry was performed by trained researchers. Body size and body mass index (BMI) were compared using Spearman's correlation coefficient. Fat distribution indicators were compared across body shapes for nonobese and obese women using analysis of variance (ANOVA) and Fisher's exact test. Percent agreement and kappa statistics were computed for apple and pear body shapes.
  
  
  RESULTS
  The 131 women studied were primarily Caucasian (81%), aged 32 years, with a mean BMI of 27.1 kg/m(2) (range 16.6-52.8 kg/m(2)). The correlation between body size and BMI was 0.85 (p<0.001). Among nonobese women, waist-to-hip ratios (WHR) were 0.75, 0.75, 0.80, and 0.82 for pear, hourglass, rectangle, and apple, respectively (p<0.001). Comparing apples and pears, the percent agreement (kappa) for WHR≥0.80 was 83% (0.55).
  
  
  CONCLUSIONS
  Self-reported size and shape were consistent with anthropometric measures commonly used to assess obesity and fat distribution, respectively. Self-reported body shape may be a useful proxy measure in addition to body size in large-scale surveys.
authors.affiliation: Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA. thomame@mail.nih.gov
authors.forename: Marie E
authors.initials: ME
authors.lastname: Thoma
authors.forename: Mary L
authors.initials: ML
authors.lastname: Hediger
authors.forename: Rajeshwari
authors.initials: R
authors.lastname: Sundaram
authors.forename: Joseph B
authors.initials: JB
authors.lastname: Stanford
authors.forename: C Matthew
authors.initials: CM
authors.lastname: Peterson
authors.forename: Mary S
authors.initials: MS
authors.lastname: Croughan
authors.forename: Zhen
authors.initials: Z
authors.lastname: Chen
authors.forename: Germaine M
authors.initials: GM
authors.lastname: Buck Louis
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D000886:Anthropometry / Q000379:methods*; D050218:Body Fat Distribution / Q000523:psychology; D001828:Body Image / Q000523:psychology*; D015992:Body Mass Index; D049628:Body Size; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007407:Interviews as Topic; D010465:Perception; D015203:Reproducibility of Results; D012307:Risk Factors; D057566:Self Report; D012959:Socioeconomic Factors; D049629:Waist-Hip Ratio / Q000523:psychology; D044465:White People; D055815:Young Adult