Aim: We aimed to evaluate the usefulness of the Body Image Assessment in Obesity (BIA-O) scale in a UK obesity clinic population by assessing its performance in individuals with a Body Mass Index (BMI) above 50 Kg/m2, evaluating whether obese subjects selected achievable reasonable body sizes, and comparing the relationship between body dissatisfaction on the Eating Disorder Inventory-2 (EDI-2) and BIA-O.
Methods: Subjects attending specialist obesity clinics were eligible for inclusion. All subjects underwent anthropometric measurements and completed a questionnaire incorporating the BIA-O. Reasonable body size on this questionnaire is defined as a size that it would be reasonable to expect an individual to maintain for a prolonged period of time.
To validate the questionnaire in patients with extreme obesity, individuals were grouped according to whether measured BMI was above or below 50 Kg/m2; men and women were evaluated separately.
Results: One hundred and eighty-one subjects were included. In both men and women there were significant positive correlations between measured BMI and current body size selected (P<0.005); however reasonable body size chosen demonstrated minimal change as BMI increased. Current body size selected was significantly greater in individuals with a BMI above 50 (P<0.005). There was a positive correlation between body dissatisfaction on EDI-2 and BIA-O in women (P<0.05).
Conclusions: The BIA-O correlated with measured BMI, however some measures may have been affected by individuals selecting figures representing the largest size, suggesting limited usefulness of this questionnaire in individuals with extreme obesity. Body dissatisfaction measured on both BIA-O and EDI-2 did not correlate well in our male population. The selection of a similar reasonable body size by men and women within both BMI groups suggests that many subjects attending for weight management at specialist centres have unrealistic goals.