slide1 n.
Skip this Video
Download Presentation
Associations of BMI with Self-Perceptions of Weight Status among Firefighters

Loading in 2 Seconds...

play fullscreen
1 / 1

Associations of BMI with Self-Perceptions of Weight Status among Firefighters - PowerPoint PPT Presentation

  • Uploaded on

Associations of BMI with Self-Perceptions of Weight Status among Firefighters. Stefanos N. Kales MD, MPH, Antonios J. Tsismenakis MA, and Sara A. Pyle PhD.

I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
Download Presentation

PowerPoint Slideshow about 'Associations of BMI with Self-Perceptions of Weight Status among Firefighters' - dean-gilliam

Download Now An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.

- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript

Associations of BMI with Self-Perceptions

of Weight Status among Firefighters

Stefanos N. Kales MD, MPH, Antonios J. Tsismenakis MA, andSara A. Pyle PhD

Harvard School of Public Health, Boston, MA (SNK, AJT); The Cambridge Health Alliance, Harvard Medical School, Cambridge, MA (SNK, AJT); Boston University School of Medicine, Boston, MA (AJT); National Development and Research Institutes, Kansas City, MO (SAP)


Approximately 45% of on-duty deaths among firefighters are attributable to cardiovascular events, and most of these incidents occur during high stress/exertion in susceptible firefighters with modifiable risk factors, including obesity. Obesity is also well-recognized to mediate risk through effects on other modifiable factors (blood pressure, lipids, glucose, etc). Several previous studies of firefighters have documented a high prevalence of overweight/obesity, as well as increases in average body mass index (BMI) over recent decades. Little is known, however, about firefighters’ self-perceptions of weight status and how these vary across BMI categories.


BMI and questionnaire data were collected from 377 consecutive medical examinations of firefighters from Kansas and Missouri. Cross-sectional analyses were performed across internationally-defined BMI categories (underweight, normal weight, overweight, obese) and self-perceived weight categories (“underweight/skinny,” “healthy/normal/muscular,” “overweight,” “obese/fat”). Analyses were performed using C2-tests for categorical variables. Statistical significance was determined by p<0.05.


None of the firefighters were underweight by BMI, 14% were of normal weight, 48% were overweight, and 38% were obese. Two percent considered themselves to be underweight, 52% healthy/normal/muscular, 40% overweight, and 4% obese/fat.

Agreement between self-perceived weight category and measured BMI decreased markedly as BMI category increased: 87% among those with normal BMI; 29% among the overweight; and 10% among the obese (p<0.001). None of the

Figure 1. Prevalence of Weight Status by BMI vs. Self Report


In agreement with previous studies, overweight and obesity were highly prevalent in our sample. However, when queried about weight status, the accuracy of firefighters’ self-perceptions was inversely related to measured BMI category. The majority (69% of overweight and 86% of obese) considered themselves to belong in lower weight categories.

Likewise, heavier subjects more frequently reported having had their weight misclassified or not mentioned at all by their primary care physicians. Approximately half of the overweight and obese subjects denied any desire to lose weight, which is likely influenced by the high prevalence of incorrect self- and physician perceptions of weight status.

The fire service and clinicians should address weight status in firefighters by using objective measures of adiposity and providing frank feedback to help guide nutrition and exercise counseling.

normal weight, 2 of the overweight, and 5 of the obese firefighters elected not to answer the question about weight status. In parallel to the firefighters’ self-perceptions, 89%, 22%, and 9%, of their primary care physicians had correctly classified the firefighters as normal weight, overweight, or obese, respectively, when these reports were compared to BMI categories (p<0.001). Additionally, 20% of overweight and 14% of obese subjects reported that their doctors had not commented on their weight.

Self-perceptions regarding desired weight change were more consonant with measured BMI: 46% of overweight and 52% of obese firefighters wanted to lose weight over the next year.

Stefanos N. Kales, MD, MPH - Employee & Industrial Medicine - The Cambridge Health Alliance - 1493 Cambridge St – Suite 427 - Cambridge, MA 02139 - Phone: 617-665-1580 - Fax: 617-665-1672 - Email: