title: Practical Considerations for Body Composition Assessment of Adults with Class II/III Obesity Using Bioelectrical Impedance Analysis or Dual-Energy X-Ray Absorptiometry.
abstract: OBJECTIVE
  The purpose of this review is to explore the practical considerations for body composition assessment of adults with class II/III obesity. Studies assessing adults (18-64 years) with a body mass index (BMI) ≥35 kg/m2with bioelectrical impedance analysis (BIA) and/or dual-energy X-ray absorptiometry (DXA) were included.
  
  
  RESULTS
  Twelve studies met inclusion criteria. Five considerations were identified: variances in equipment and technology, equipment weight capacity, subject positioning, tissue penetration, and total body hydration. In subjects with BMI ≥35 kg/m2, BIA overestimated fat-free mass with scaling errors as BMI increased. DXA provided accurate and reliable body composition measures, but equipment-related barriers prevented assessment of some taller, wider, and heavier subjects. BIA is an unreliable method to assess body composition in class II/III obesity. Advancements in DXA technology (e.g., iDXA), methodology (e.g., subject positioning, longer scan times), and more inclusive testing criteria (e.g., use equipment limits not just BMI) may improve access and understanding of body composition in this cohort.
authors: Department of Agricultural, Food and Nutritional Science, University of Alberta, 4-002 Li Ka Shing Centre, Room 2-021E, 8602-112th Street, Edmonton, T6G 2E1, AB, Canada. cajohnso@ualberta.ca.
authors: Carlene A
authors: CA
authors: Johnson Stoklossa
authors: Department of Occupational Therapy, University of Alberta, Edmonton, Alberta, Canada.
authors: Mary
authors: M
authors: Forhan
authors: Department of Medicine, University of Alberta; Alberta Diabetes Institute, Edmonton, Alberta, Canada.
authors: Raj S
authors: RS
authors: Padwal
authors: Postgraduate Program on Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil.
authors: Maria Cristina
authors: MC
authors: Gonzalez
authors: Department of Agricultural, Food and Nutritional Science, University of Alberta, 4-002 Li Ka Shing Centre, Room 2-021E, 8602-112th Street, Edmonton, T6G 2E1, AB, Canada. cprado@ualberta.ca.
authors: Carla M
authors: CM
authors: Prado
mesh_terms: D015502:Absorptiometry, Photon; D000273:Adipose Tissue / Q000000981:diagnostic imaging / Q000503:physiopathology*; D000328:Adult; D001823:Body Composition / Q000502:physiology*; D017097:Electric Impedance; D006801:Humans; D009765:Obesity / Q000000981:diagnostic imaging / Q000503:physiopathology*