The Bias in Self‐reported Obesity From 1976 to 2005: A Canada–US Comparison

The objective of this study was to determine whether the bias in self-reported estimates of obesity has changed over time and followed different patterns in Canada and the United States. Using age-standardized data from three waves of the National Health and Nutrition Examination Survey (NHANES) in the United States and the Canadian Community Health Survey (CCHS) and the Canadian Heart Health Survey (CHHS) in Canada, discrepancies were compared between reported and measured estimates of height, weight, and obesity (based on the BMI) from 1976 to 2005. Results indicated that obesity increased in both countries, but rates were higher in the United States. The discrepancy between self-reported and measured obesity was small in the United States with reported data underestimating measured prevalence by about 3%; this stayed relatively constant over time. In Canada, the discrepancy was large and doubled in the past decade (from 4 to 8%). In the United States, self-reported data may be more accurate in monitoring changes in obesity over time, as the estimates have consistently remained about 3% below the measured estimates, whereas in Canada, monitoring obesity based solely on self-reported height and weight may produce inaccurate estimates because of the increasing discrepancy between self-reported and measured data.