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Practical Considerations for Body Composition Assessment of Adults with Class II/III Obesity Using Bioelectrical Impedance Analysis or Dual-Energy X-Ray Absorptiometry

  • Metabolism (J Proietto, Section Editor)
  • Published:
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Abstract

Purpose of Review

The purpose of this review is to explore the practical considerations for body composition assessment of adults with class II/III obesity. Studies assessing adults (18–64 years) with a body mass index (BMI) ≥35 kg/m2 with bioelectrical impedance analysis (BIA) and/or dual-energy X-ray absorptiometry (DXA) were included.

Recent Findings

Twelve studies met inclusion criteria. Five considerations were identified: variances in equipment and technology, equipment weight capacity, subject positioning, tissue penetration, and total body hydration. In subjects with BMI ≥35 kg/m2, BIA overestimated fat-free mass with scaling errors as BMI increased. DXA provided accurate and reliable body composition measures, but equipment-related barriers prevented assessment of some taller, wider, and heavier subjects.

Summary

BIA is an unreliable method to assess body composition in class II/III obesity. Advancements in DXA technology (e.g., iDXA), methodology (e.g., subject positioning, longer scan times), and more inclusive testing criteria (e.g., use equipment limits not just BMI) may improve access and understanding of body composition in this cohort.

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Acknowledgments

The authors appreciate the support of Drs. Catherine Field and Sarah Elliott for their review of an earlier draft of the manuscript.

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Authors and Affiliations

  1. Department of Agricultural, Food and Nutritional Science, University of Alberta, 4-002 Li Ka Shing Centre, Room 2-021E, 8602–112th Street, Edmonton, T6G 2E1, AB, Canada

    Carlene A. Johnson Stoklossa & Carla M. Prado

  2. Department of Occupational Therapy, University of Alberta, Edmonton, Alberta, Canada

    Mary Forhan

  3. Department of Medicine, University of Alberta; Alberta Diabetes Institute, Edmonton, Alberta, Canada

    Raj S. Padwal

  4. Postgraduate Program on Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil

    Maria Cristina Gonzalez

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  1. Carlene A. Johnson Stoklossa
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  2. Mary Forhan
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  5. Carla M. Prado
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Corresponding authors

Correspondence to Carlene A. Johnson Stoklossa or Carla M. Prado.

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Conflict of Interest

Carlene A. Johnson Stoklossa, Mary Forhan, Raj S. Padwal, Maria Cristina Gonzalez, and Carla M. Prado declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Metabolism

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Johnson Stoklossa, C.A., Forhan, M., Padwal, R.S. et al. Practical Considerations for Body Composition Assessment of Adults with Class II/III Obesity Using Bioelectrical Impedance Analysis or Dual-Energy X-Ray Absorptiometry. Curr Obes Rep 5, 389–396 (2016). https://doi.org/10.1007/s13679-016-0228-5

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