Accuracy of self-reported weight and height and resulting body mass index among obese binge eaters in primary care: relationship with eating disorder and associated psychopathology.

Research with eating and weight disorders sometimes requires reliance upon self-reported weight and height data because of the impracticality of obtaining actual measurements. This practice is supported by well-known findings that, in general, self-reported weight is highly correlated with measured weight.1 Although individuals report their weight reasonably accurately, research has found that there tends to be bias toward underreporting weight and overreporting height.2 Underreporting weight tends to increase with increasing overweight, and the degree of inaccuracy of self-reported weight and height varies with a number of characteristics, including age, sex, ethnicity, and education.2,3 The degree of weight underestimation tends to vary across patient groups, with obese persons showing greater inaccuracy.3–6 Interestingly, the few studies that have examined this issue in persons with eating disorders have found that these patient groups tend to be more accurate than other groups,7,8 including patients with binge-eating disorder (BED) who were also obese.9 Systematic biases such as these can have substantial implication for research findings as well as perceptions regarding obesity.3,10 Obese patients with BED represent an important group for studying systematic biases in weight and height reporting, given that eating disorders have been associated with greater accuracy and obesity has been associated with greater inaccuracy. Masheb and Grilo9 found that, among a clinical sample of patients with comorbid obesity and BED, the degree of weight discrepancy was not related to eating disorder psychopathology, depression, or self-esteem. The lack of relationship between self-report discrepancy and psychopathology has also been found in several studies with obese women5,9,11 and, most recently, in a large epidemiologic study with a wide range of body mass indices (BMIs).12 In contrast, Meyer and colleagues13 recently reported that high eating concerns predicted weight overestimation and high weight concerns predicted weight underestimation in a nonclinical sample of female college students. Binge-eating disorder is a common clinical problem in primary care settings, but—despite its association with increased health service utilization, health problems, and psychosocial impairment14,15—it is frequently overlooked by health care providers in these settings.14–17 Obese persons with BED who present to general medical settings may differ in important ways from obese persons with BED who seek psychological or behavioral treatments at specialty clinics.9 For example, it is possible that treatment seeking at specialty psychiatry clinics may be associated with distress related to weight, eating, or body image,18,19 whereas obese persons who present to primary care facilities may have different priorities (eg, heightened medical concerns). Thus, the present study aimed to examine the accuracy of self-reported weight and height among obese binge eaters in primary care settings and to explore possible relationships with demographic and clinical variables, including eating disorder and associated psychological features. Clinical Points ♦ Binge-eating disorder is a common clinical problem associated with obesity in primary care settings but may be frequently overlooked by health care providers. ♦ Obese patients with binge-eating disorder in primary care settings are reasonably accurate reporters of their weight, but they may modestly overestimate their height, which leads to underestimations of their resulting body mass index. ♦ The degree of self-reported height and weight inaccuracy in obese patients with binge-eating disorder does not appear to be systematically related to eating disorder psychopathology or depressive features.