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Beyond BMI: The Value of More Accurate Measures of Fatness and Obesity in Social Science Research

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  • John Cawley
  • Richard V. Burkhauser

Abstract

Virtually all social science research related to obesity uses body mass index (BMI), usually calculated using self-reported values of weight and height, or clinical weight classifications based on BMI. Yet there is wide agreement in the medical literature that such measures are seriously flawed because they do not distinguish fat from fat-free mass such as muscle and bone. Here we evaluate more accurate measures of fatness (total body fat, percent body fat, and waist circumference) that have greater theoretical support in the medical literature. We provide conversion formulas based on NHANES data so that researchers can calculate the estimated values of these more accurate measures of fatness using the self-reported weight and height available in many social science datasets. To demonstrate the benefits of these alternative measures of fatness, we show that using them significantly impacts who is classified as obese. For example, when the more accurate measures of fatness are used, the gap in obesity between white and African American men increases substantially, with white men significantly more likely to be obese. In addition, the gap in obesity between African American and white women is cut in half (with African American women still significantly more likely to be obese). As an example of the value of fatness in predicting social science outcomes, we show that while BMI is positively correlated with the probability of employment disability in the PSID, when body mass is divided into its components, fatness is positively correlated with disability while fat-free mass (such as muscle) is negatively correlated with disability.

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Bibliographic Info

Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 12291.

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Date of creation: Jun 2006
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Publication status: published as Burkhauser, Richard V., and John Cawley. "Beyond BMI: The Value of More Accurate Measures of Fatness and Obesity in Social Science Research." Journal of Health Economics, March 2008, 27(2): 519-529.
Handle: RePEc:nbr:nberwo:12291

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  1. Dalton Conley & Rebecca Glauber, 2005. "Gender, Body Mass and Economic Status," NBER Working Papers 11343, National Bureau of Economic Research, Inc.
  2. John Cawley & Sheldon Danziger, 2005. "Morbid obesity and the transition from welfare to work," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 24(4), pages 727-743.
  3. Dean Jolliffe, 2004. "Continuous and robust measures of the overweight epidemic: 1971–2000," Demography, Springer, vol. 41(2), pages 303-314, May.
  4. Richard V. Burkhauser & John Cawley, 2004. "Obesity, Disability, and Movement Onto the Disability Insurance Rolls," Working Papers wp089, University of Michigan, Michigan Retirement Research Center.
  5. Chou, Shin-Yi & Grossman, Michael & Saffer, Henry, 2004. "An economic analysis of adult obesity: results from the Behavioral Risk Factor Surveillance System," Journal of Health Economics, Elsevier, vol. 23(3), pages 565-587, May.
  6. Darius Lakdawalla & Dana Goldman & Jay Bhattacharya, 2001. "Are the Young Becoming More Disabled?," NBER Working Papers 8247, National Bureau of Economic Research, Inc.
  7. Darius Lakdawalla & Tomas Philipson, 2002. "The Growth of Obesity and Technological Change: A Theoretical and Empirical Examination," Working Papers 0203, Harris School of Public Policy Studies, University of Chicago.
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