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Background <p>Bariatric surgery results in body composition changes, but direct assessment is often unavailable in clinical settings. Prediction equations offer an alternative but remain unvalidated, especially in people with obesity. This study evaluated the accuracy of anthropometric-based equations for estimating fat mass (FM)%, FM, and lean soft tissue (LST) in females awaiting bariatric surgery.</p> Methods <p>Females with class II or III obesity underwent body composition assessment via dual X-ray absorptiometry. The accuracy of 16 body composition equations was determined using Bland-Altman analyses, assessing group-level (bias: mean difference, via paired t-test) and individual-level (limits of agreement [LOA]; bias ± 2 standard deviations) agreement. Pearson’s or Spearman’s correlation assessed proportional bias and the relationship between equation error and age, weight, waist circumference, and waist-to-height ratio.</p> Results <p>One hundred twenty-nine females (body mass index: 43.4 ± 6.2&#xa0;kg/m<sup>2</sup>; age: 44 ± 12 years) were included. Most equations (12/16; 75%) differed from measured values on a group level, and individual-level agreement was generally poor. Equations from Woolcott et al. (FM% LOA: -7.7, 8.3%) and Lee et al. (equation&#xa0;2: FM LOA: -9.1, 10.1; LST LOA: -6.9, 10.7&#xa0;kg) showed the narrowest LOA. Proportional bias was present in most equations (12/16; 75%), with biases in FM% and LST often correlated with body weight, waist circumference, and waist-to-height ratio.</p> Conclusions <p>No equation provided accurate individual-level body composition estimates, though some performed reasonably well at the group level. Improved prediction models or accessible measurement methods are needed for accurate body composition evaluation before and after bariatric surgery.</p>

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Accuracy of Body Composition Prediction Equations in Middle-Aged Females with Class II and III Obesity

  • 期刊论文

  • 发表日期：

    2026年1月7日

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  • Sarah A Purcell,
  • Jonathan P Bennett,
  • Carlene A Johnson-Stoklossa,
  • Mario Siervo,
  • Carla M Prado

摘要

Background

Bariatric surgery results in body composition changes, but direct assessment is often unavailable in clinical settings. Prediction equations offer an alternative but remain unvalidated, especially in people with obesity. This study evaluated the accuracy of anthropometric-based equations for estimating fat mass (FM)%, FM, and lean soft tissue (LST) in females awaiting bariatric surgery.

Methods

Females with class II or III obesity underwent body composition assessment via dual X-ray absorptiometry. The accuracy of 16 body composition equations was determined using Bland-Altman analyses, assessing group-level (bias: mean difference, via paired t-test) and individual-level (limits of agreement [LOA]; bias ± 2 standard deviations) agreement. Pearson’s or Spearman’s correlation assessed proportional bias and the relationship between equation error and age, weight, waist circumference, and waist-to-height ratio.

Results

One hundred twenty-nine females (body mass index: 43.4 ± 6.2 kg/m2; age: 44 ± 12 years) were included. Most equations (12/16; 75%) differed from measured values on a group level, and individual-level agreement was generally poor. Equations from Woolcott et al. (FM% LOA: -7.7, 8.3%) and Lee et al. (equation 2: FM LOA: -9.1, 10.1; LST LOA: -6.9, 10.7 kg) showed the narrowest LOA. Proportional bias was present in most equations (12/16; 75%), with biases in FM% and LST often correlated with body weight, waist circumference, and waist-to-height ratio.

Conclusions

No equation provided accurate individual-level body composition estimates, though some performed reasonably well at the group level. Improved prediction models or accessible measurement methods are needed for accurate body composition evaluation before and after bariatric surgery.