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The aim of this work was to assess the accuracy of physicians' subjective assessments of obesity status. The subjects were participants in The Second National Health and Nutrition Examination (NHANES II) Survey. The physicians' subjective judgments of obesity were compared to BMI, an objective measure of actual body mass. Subjects with a body mass index (BMI = weight in kg/(height in cm/100)2) less than or equal to 27.5 were classified as normal weight and those with a BMI greater than or equal to 30.4 were considered to be obese. Physicians were accurate in their diagnosis of the normal weight group with only 4.03% being misdiagnosed as obese. However, 12.6% of the obese group was misdiagnosed as normal weight. The odds of an incorrect normal weight diagnosis increased with age. Similarly, as the fat distribution ratio increased, i.e., a more central pattern, the odds of being actually obese but incorrectly diagnosed as normal weight increased. Men were more likely than women to be incorrectly diagnosed as normal weight. Non-Caucasian normal weight persons appear to have been diagnosed more stringently than Caucasians as they were more likely to be misdiagnosed as obese regardless of their gender. There appear to be several variables affecting the physicians' subjective assessment of obesity status in this data set.

A large cohort of children was divided into two groups based on their parents' weight status. The high risk group had one or two overweight parent(s) (n = 92, 4.4 +/- 0.5 years), while the low risk group had no parent overweight (n = 95, 4.5 +/- 0.5 years). Weight of the two groups was similar at the start of the study but the high risk group gained marginally more weight over a one year period (P = 0.05). Although total energy intake was similar, the high risk group was consuming a larger percentage of energy from fat (P = 0.0004) and a smaller percentage from carbohydrate (P = 0.0002). Observed physical activity as similar for most levels but marginally higher for the stationary level and marginally lower in total activity in the high risk group. These results suggest a pattern that may lead to increased weight gain in a high risk group as they grow older.

This investigation evaluated the impact of parental influences on children's food selections and the impact of childhood obesity on these food choices. Subjects were 53 young children of various weight status. Foods ranging widely in nutritional values were offered to each child for lunch. The children were again offered foods but were told that their mothers would be monitoring their selections. Finally, mothers were allowed to modify their children's last food choices. Results indicated that parental influences have a marked effect on food selection; both the threat of parental monitoring and actual parental monitoring lowered the number of nonnutritious foods chosen and total caloric content of the meal. The obesity status of the mothers and children had no impact on these results. The implication of these results for future intervention efforts are discussed.

This investigation determined the accuracy of self-reports of physical activity compared to observations obtained surreptitiously. Subjects were 44 adults engaged in 1 h of their preferred physical activity while actual activity levels were surreptitiously obtained and compared to immediate self-reported estimates of physical activity. Results indicated that subjects were moderately accurate in recalling their physical activity levels (R = 0.62) but underestimated sedentary activities and overestimated aerobic activities by over 300%. Males overestimated their activity relative to females, and obese subjects underestimated their activity levels compared to normal-weight subjects. Finally, a number of two-way interactions that moderated the accuracy of those subjects engaging in high chronic levels of physical activity were observed.

The effects of having diabetes or obesity on simulated job decisions was evaluated in a two (qualifications, high v. marginal) by three (diabetes, mildly obese, or normal) design. Subjects were 295 adults, averaging 5.02 years of full-time employment in white-collar settings, recruited in advanced level graduate or undergraduate business classes. Each subject examined a job description and a resume of the 'applicant' and viewed a 5-minute videotape. The applicant's face was never seen and an off-camera voice, constant across all conditions, was dubbed in for the applicant's responses to the interviewer's questions. Subjects were then asked to rate the applicant's qualification level and demeanor during the interview and to recommend whether or not to hire the individual. Subjects were also asked to make ratings about the applicant's work habits, work reliability and absenteeism, and interpersonal skills (e.g. emotional problems, likeability). Results indicated that level of quantification affected decisions to hire the applicant in the predicted direction. However, the obese applicant was rated as less qualified for the job, and both the diabetic and obese applicant were less likely to be hired, although they were rated similarly on personal appearance, attitude during the interview, and communication skills. Additionally, both the obese and the diabetic applicant were viewed as having poorer work habits. The diabetic was rated as much more likely to have medically-related job absences, whereas the obese applicant was rated as more likely to have other absences (e.g. abusing company privileges by feigning illness) and to have emotional and interpersonal problems.(ABSTRACT TRUNCATED AT 250 WORDS)

Examined demographic, environmental, and parent-child interactional correlates of physical activity in a group of 222 preschoolers. Activity levels were assessed with a system that quantified directly observed physical activity in the natural environment. Using regression-modeling procedures, results revealed a significant relationship between (a) child's relative weight, parental weight status, and percentage of time spent outdoors (environment) and (b) children's activity levels. Parental obesity was associated with lower levels of physical activity in children, childhood relative weight was associated with slightly higher levels of physical activity, and more outdoor activity was associated with higher activity levels. Parental participation in children's activities also significantly interacted with levels of parental obesity in predicting activity levels. Those children with a 50% risk for obesity (as defined by both, one, or neither parent being overweight) had small changes in activity across levels of parent-child interaction, whereas those at higher risk for obesity responded with increased activity as parent-child interactions increased. Results are discussed, and the implications of these findings for future intervention efforts are examined.

The purpose of this investigation was to determine the accuracy of dietary-intake information of normal-weight vs overweight parents in their reports of their children's food intake. Subjects were 36 families with either normal-weight (n = 20) or overweight (n = 16) children aged 4-9 y. Unobtrusive observers recorded the types and amounts of food eaten by the children at one meal. The next day families were visited in their homes and were asked to provide dietary-intake information from the previous day on their child. Results indicated that parental reports of the dietary intake of their children correlated significantly with the observers' measures of food intake. Neither the father's, the mother's, nor the family's obesity status had an effect on the accuracy of recalled information. The results indicated that the lack of differences consistently observed in dietary intake between obese and normal-weight children could not be explained by differential accuracy of recalled dietary information.

The purpose of this study was to determine the accuracy of self-reported 24-h dietary recalls of overweight and normal-weight adults. Forty female college students (21 overweight, 19 normal weight) consumed a lunch meal at the university cafeteria while being unobtrusively observed. The following day subjects returned to the lab and completed a 24-h recall of their food intake. Accuracy of recalls was assessed by comparing directly observed intake with self-reported intake. Correlated t tests comparing observed and reported intake found a significant amount of overreporting of consumption for the entire sample. When analyses were conducted on individual groups (normal weight vs overweight), no between-group differences were found. A series of one-way analyses of variance (ANOVA) (normal weight vs overweight) and a multivariate ANOVA were performed for total calories, nutrients, and the amount of over- and underreporting. No significant differences between groups were observed.