title: The use of Stunkard's figure rating scale to identify underweight and overweight in Chinese adolescents.
abstract: BACKGROUND
  To compare the performance of Stunkard's current body size (CBS) with self-reported body mass index (BMI), waist circumference (WC) and waist to stature ratio (WSR) in predicting weight status in Chinese adolescents, and to determine the CBS cutoffs for overweight/obesity and underweight.
  
  
  METHODS
  This cross-sectional study was conducted in a sample of 5,418 secondary school students (45.2% boys; mean age 14.7 years). Height and weight were measured by trained teachers or researchers. Subjects were classified as underweight, normal weight, or overweight/obese according to the International Obesity Task Force cutoffs. Subjects were asked to select the figure that best resembled their CBS on the Stunkard's figure rating scale. Self-reported height, weight, WC and WSR were also obtained. The performance of CBS, self-reported BMI, WC and WSR as a weight status indicator was analysed by sex-specific receiver operating characteristic curves. The optimal CBS cutoffs for underweight and overweight/obesity were determined based on the Youden Index.
  
  
  RESULTS
  Apart from self-reported BMI, CBS had the greatest area under curve (AUC) for underweight in boys (0.82) and girls (0.81). For overweight/obesity, CBS also had a greater AUC (0.85) than self-reported WC and WSR in boys, and an AUC (0.81) comparable to self-reported WC and WSR in girls. In general, CBS values of 3 and 5 appeared to be the optimal cutoffs for underweight and overweight/obesity, respectively, in different sex-age subgroups.
  
  
  CONCLUSIONS
  CBS is a potentially useful indicator to assess weight status of adolescents when measured and self-reported BMI are not available.
authors.affiliation: School of Public Health, University of Hong Kong, Pokfulam, Hong Kong.
authors.forename: Wing-Sze
authors.initials: WS
authors.lastname: Lo
authors.forename: Sai-Yin
authors.initials: SY
authors.lastname: Ho
authors.forename: Kwok-Kei
authors.initials: KK
authors.lastname: Mak
authors.forename: Tai-Hing
authors.initials: TH
authors.lastname: Lam
mesh_terms: D000293:Adolescent; D044466:Asian People; D049628:Body Size; D002648:Child; D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D050177:Overweight / Q000175:diagnosis*; D012372:ROC Curve; D012016:Reference Values; D057566:Self Report; D013851:Thinness / Q000175:diagnosis*