Mueller Kirsten G, Hurt Ryan T, Abu-Lebdeh Haitham S, Mueller Paul S
Division of General Internal Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905 Minnesota.
Division of General Internal Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905 Minnesota ; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.
BMC Obes. 2014 Dec 12;1:26. doi: 10.1186/s40608-014-0026-0. eCollection 2014.
No study has compared patients' self-reported heights and weights (and resultant self-reported body mass indexes [BMIs]) with their actual heights, weights, and BMIs; their self-perceived BMI categories; and their desired weights and BMIs and determined rates of clinicians' documented diagnoses of overweight and obesity in affected patients in a single patient group. The objectives of this study were to make these comparisons, determine patient factors associated with accurate self-perceived BMI categorization, and determine the frequency of clinicians' documented diagnoses of overweight and obesity in affected patients.
A total of 508 consecutive adult general internal medicine outpatients (257 women, 251 men; mean age, 62.9 ± 14.9 years) seen at Mayo Clinic in Rochester, Minnesota, between November 9 and 20, 2009, completed a questionnaire in which they reported their heights, weights, self-perceived BMI categories ("underweight," "about right," "overweight," or "obese"), and desired weights. These self-reported data were compared to actual heights, actual weights, and actual BMI categories (measured after the questionnaire was completed). Overall, 70% of the patients were overweight or obese. The average self-reported weight was significantly lower than the average actual weight (80.3 ± 20.1 kg vs 81.9 ± 21.1 kg; P < .001). The average self-reported BMI was significantly lower than the average actual BMI (27.6 ± 5.7 kg/m(2) vs 28.3 ± 6.1 kg/m(2); P < .001). Overall, 32% of patients had obesity; however, only 6% perceived they were obese. Accuracy of self-perceived BMI category decreased with higher actual BMI category (P < .001 for trend). Female sex, higher education level, smoking status, and lower BMI were associated with higher accuracy of self-perceived BMI category. Desired weight loss increased with higher self-perceived and actual BMI categories (P < .001 for trends). Of the 165 patients who actually were obese, only 40 (24%) had obesity documented as a diagnosis in their medical records by their clinicians. Statistical tests used were the paired t test, the Pearson χ2 test, the Cochrane-Armitage trend test, the Wald test of marginal homogeneity, analysis of variance, and univariate and multivariate logistic regression.
Many obese patients inaccurately perceive their BMI categories; accuracy decreases with increasing BMI. Clinicians should inform patients of their BMIs and prescribe treatment plans for those with overweight and obesity.
尚无研究对患者自我报告的身高、体重（以及由此得出的自我报告的体重指数[BMI]）与他们的实际身高、体重和BMI；他们自我感知的BMI类别；以及他们期望的体重和BMI进行比较，并确定在单一患者群体中临床医生记录的受影响患者超重和肥胖诊断率。本研究的目的是进行这些比较，确定与准确自我感知BMI分类相关的患者因素，并确定临床医生记录的受影响患者超重和肥胖诊断的频率。
2009年11月9日至20日期间，在明尼苏达州罗切斯特市梅奥诊所就诊的508名连续的成年普通内科门诊患者（257名女性，251名男性；平均年龄62.9±14.9岁）完成了一份问卷，他们在问卷中报告了自己的身高、体重、自我感知的BMI类别（“体重过轻”、“正常”、“超重”或“肥胖”）以及期望体重。将这些自我报告的数据与实际身高、实际体重和实际BMI类别（问卷完成后测量）进行比较。总体而言，70%的患者超重或肥胖。自我报告的平均体重显著低于实际平均体重（80.3±20.1千克对81.9±21.1千克；P<.001）。自我报告的平均BMI显著低于实际平均BMI（27.6±5.7千克/平方米对28.3±6.1千克/平方米；P<.001）。总体而言，32%的患者患有肥胖症；然而，只有6%的患者认为自己肥胖。自我感知BMI类别的准确性随着实际BMI类别的升高而降低（趋势P<.001）。女性、较高的教育水平、吸烟状况和较低的BMI与自我感知BMI类别的较高准确性相关。期望的体重减轻随着自我感知和实际BMI类别的升高而增加（趋势P<.001）。在165名实际肥胖的患者中，只有40名（24%）在其病历中有临床医生记录的肥胖诊断。使用的统计检验包括配对t检验、Pearson卡方检验、Cochrane-Armitage趋势检验、边际同质性的Wald检验、方差分析以及单变量和多变量逻辑回归。
许多肥胖患者对自己的BMI类别感知不准确；准确性随着BMI的增加而降低。临床医生应告知患者他们的BMI，并为超重和肥胖患者制定治疗计划。
