Skip to main navigation menu Skip to main content Skip to site footer

Original article

Vol. 145 No. 0708 (2015)

Accuracy of doctors’ anthropometric measurements in general practice

  • Paul Sebo
  • Dagmar Haller
  • Antoinette Pechère-Bertschi
  • Patrick Bovier
  • François Herrmann
Cite this as:
Swiss Med Wkly. 2015;145:w14115


PURPOSE: There is increasing pressure on general practitioners (GPs) to identify patients with abdominal obesity in order to reduce the life-threatening consequences of this condition in the population. We aimed to confirm previous findings on the inaccuracy of anthropometric measurements performed by GPs in an academic primary care clinic and to assess the effect of theoretical training to improve the quality of these measurements.

METHODS: This cross-sectional study involved 26 GPs from private practices in Geneva, Switzerland. They were asked to measure weight, height, waist and hip circumference on ten volunteers within their practice. Two trained research assistants repeated the measurementss after the GPs (“gold standard”). The GPs were then randomised to receive information detailing the correct method for taking measurements (intervention, 14 doctors) or simple information about obesity (control, 12 doctors). Measurements were repeated a few weeks later. Measurement error was computed by comparing the GPs’ values with the average value of two measurements taken in turn by the research assistants, and agreement was examined by Bland-Altman plots. The GPs’ skills were assessed through auto-questionnaire and direct observation.

RESULTS: All measurements except height were prone to measurement error, the least affected being weight (and therefore body mass index [BMI]). Following training, measurement errors were slightly less prominent in the intervention group. GPs’ skills in measuring waist and hip circumference were frequently assessed as inadequate, but showed improvement after training.

CONCLUSIONS: Without proper training, priority should be given to using classical anthropometric measurements (i.e. weight, height and BMI determination) in daily practice.


  1. Finucane MM, Stevens GA, Cowan MJ, Danaei G, Lin JK, Paciorek CJ, et al. National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9·1 million participants. Lancet. 2011;377:557–67.
  2. Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384:766–81.
  3. Schneider H, Dietrich ES, Venetz WP. Trends and stabilization up to 2022 in overweight and obesity in Switzerland, comparison to France, UK, US and Australia. Int J Environ Res Public Health. 2010;7:460–72.
  4. Marques-Vidal P, Paccaud F. Regional differences in self-reported screening, prevalence and management of cardiovascular risk factors in Switzerland. BMC Public Health. 2012;12:246.
  5. Enquête suisse sur la santé 2012. Office fédéral de la statistique (OFS): Neuchâtel, 2012 (accessed 23 Nov2013).
  6. World Health Organization. Global health risks: mortality and burden of disease attributable to selected major risks. World Health Organization: Geneva, Switzerland, 2009.
  7. Flegal KM, Kit BK, Orpana H, Graubard BI. Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. JAMA. 2013;309:71–82.
  8. Obesity: The Prevention, Identification, Assessment and Management of Overweight and Obesity in Adults and Children. National Institute for Health and Clinical Excellence (UK): London, 2006.
  9. Lau DCW, Douketis JD, Morrison KM, Hramiak IM, Sharma AM, Ur E. 2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children [summary]. CMAJ. 2007;176:S1–13.
  10. Siren R, Eriksson JG, Vanhanen H. Waist circumference a good indicator of future risk for type 2 diabetes and cardiovascular disease. BMC Public Health. 2012;12:631.
  11. Lean ME, Han TS, Morrison CE. Waist circumference as a measure for indicating need for weight management. BMJ. 1995;311:158–61.
  12. Pouliot MC, Després JP, Lemieux S, Moorjani S, Bouchard C, Tremblay A, et al. Waist circumference and abdominal sagittal diameter: best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women. Am J Cardiol. 1994;73:460–8.
  13. Zamboni M, Turcato E, Armellini F, Kahn HS, Zivelonghi A, Santana H, et al. Sagittal abdominal diameter as a practical predictor of visceral fat. Int J Obes Relat Metab Disord. 1998;22:655–60.
  14. Wang J. Waist circumference: a simple, inexpensive, and reliable tool that should be included as part of physical examinations in the doctor’s office. Am J Clin Nutr. 2003;78:902–3.
  15. Chen MM, Lear SA, Gao M, Frohlich JJ, Birmingham CL. Intraobserver and interobserver reliability of waist circumference and the waist-to-hip ratio. Obes Res. 2001;9:651.
  16. Moreno LA, Joyanes M, Mesana MI, González-Gross M, Gil CM, Sarría A, et al. Harmonization of anthropometric measurements for a multicenter nutrition survey in Spanish adolescents. Nutrition. 2003;19:481–6.
  17. Nordhamn K, Södergren E, Olsson E, Karlström B, Vessby B, Berglund L. Reliability of anthropometric measurements in overweight and lean subjects: consequences for correlations between anthropometric and other variables. Int J Obes Relat Metab Disord. 2000;24:652–7.
  18. Sebo P, Beer-Borst S, Haller DM, Bovier PA. Reliability of doctors’ anthropometric measurements to detect obesity. Prev Med. 2008;47:389–93.
  19. Sebo P, Pechère-Bertschi A, Herrmann FR, Haller DM, Bovier P. Blood pressure measurements are unreliable to diagnose hypertension in primary care. J Hypertens. 2014;32:509–17.
  20. Assmann G, Carmena R, Cullen P, Fruchart JC, Jossa F, Lewis B, et al. Coronary heart disease: reducing the risk: a worldwide view. International Task Force for the Prevention of Coronary Heart Disease. Circulation. 1999;100:1930–8.
  21. Lean ME, Han TS, Deurenberg P. Predicting body composition by densitometry from simple anthropometric measurements. Am J Clin Nutr. 1996;63:4–14.
  22. National Health and Nutrition Examination Survey III (NAHNES III). Body Measurements (Anthropometry). (accessed 21 Feb 2013).
  23. Health Canada. National Nutrition Survey. PEI Nutrition Survey. Interviewer Training Manual 1995.
  24. Government of Canada HC. ARCHIVED – Canadian Guidelines for Body Weight Classification in Adults. 2004. (accessed 16 Nov2013).
  25. Harrell FE, Lee KL, Califf RM, Pryor DB, Rosati RA. Regression modelling strategies for improved prognostic prediction. Stat Med. 1984;3:143–52.
  26. Shapiro SS, Francia RS. An Approximate Analysis of Variance Test for Normality. Journal of the American Statistical Association. 1972;67:215–6.
  27. Ulijaszek SJ, Kerr DA. Anthropometric measurement error and the assessment of nutritional status. Br J Nutr. 1999;82:165–77.
  28. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1:307–10.
  29. DiMaria-Ghalili RA. Medical record versus researcher measures of height and weight. Biol Res Nurs. 2006;8:15–23.
  30. Sicotte M, Ledoux M, Zunzunegui M-V, Ag Aboubacrine S, Nguyen V-K. Reliability of anthropometric measures in a longitudinal cohort of patients initiating ART in West Africa. BMC Med Res Methodol. 2010;10:102.
  31. Bosy-Westphal A, Booke C-A, Blöcker T, Kossel E, Goele K, Later W, et al. Measurement site for waist circumference affects its accuracy as an index of visceral and abdominal subcutaneous fat in a Caucasian population. J Nutr. 2010;140:954–61.
  32. Mason C, Katzmarzyk PT. Variability in waist circumference measurements according to anatomic measurement site. Obesity. (Silver Spring) 2009;17:1789–95.
  33. Dhaliwal SS, Welborn TA. Measurement error and ethnic comparisons of measures of abdominal obesity. Prev Med. 2009;49:148–52.
  34. Nádas J, Putz Z, Kolev G, Nagy S, Jermendy G. Intraobserver and interobserver variability of measuring waist circumference. Med Sci Monit. 2008;14:CR15–18.
  35. Panoulas VF, Ahmad N, Fazal AA, Kassamali RH, Nightingale P, Kitas GD, et al. The inter-operator variability in measuring waist circumference and its potential impact on the diagnosis of the metabolic syndrome. Postgrad Med J. 2008;84:344–7.
  36. Chumlea WC, Guo S, Kuczmarski RJ, Johnson CL, Leahy CK. Reliability for anthropometric measurements in the Hispanic Health and Nutrition Examination Survey (HHANES 1982–1984). Am J Clin Nutr. 1990;51:902S–907S.

Most read articles by the same author(s)