Trends in National and State-Level Obesity in the USA after Correction for Self-Report Bias: Analysis of Health Surveys

Abstract

ObjectivesTo quantify population-level bias in self-reported weight and height as a function of age, sex, and the mode of self-report, and to estimate unbiased trends in national and state level obesity in the USA.DesignStatistical analysis of repeated cross-sectional health examination surveys (the National Health and Nutrition Examination Survey [NHANES]) and health surveys (the Behavioral Risk Factor Surveillance System [BRFSS]) in the USA.SettingThe 50 states of the USA and the District of Columbia.ResultsIn the USA, on average, women underreported their weight, but men did not. Young and middle-aged (565 years) adult men over-reported their height more than women of the same age. In older age groups, over-reporting of height was similar in men and women. Population-level bias in self-reported weight was larger in telephone interviews (BRFSS) than in-person interviews (NHANES). Except in older adults, height was over-reported more often in telephone interviews than in-person interviews. Using correcte...