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Objective: To assess the reliability of a BMI-based Silhouette Matching Test (BMI-SMT). Methods: The perceptions of ideal and current body images of 215 ninth through twelfth graders' were assessed at 5 different schools within a mid-Atlantic state public school system. Results: Findings provided quantifiable data and discriminating measurements of community and population-based body image perceptions. Conclusions: The BMI-SMT technique provided reliable information to help community and individual-based programs track and measure body-image perception data among individuals and populations.
Key words: body image, body mass index, silhouette test, perceptions, assessment
Am J Health Behav 2003;27(4):355-363
With the current cultural emphasis on outward appearance, body size, and body fat, many adolescents have become overly preoccupied with their appearance and feeling overweight.1-3 The adolescent infatuation with the cultural icon of thinness has contributed to a covey of unhealthy behaviors such as excessive or extreme dieting,1 unhealthy eating patterns and preoccupation with food and self,4 lower self-esteem,5-7 social introversion,8 drug and alcohol abuse,9,10 and general physical and mental ill health.4,11 As a result community health professionals have undertaken many initiatives to address body dissatisfaction issues as a means of preventing the adoption of poor health behaviors, and reducing potential risk of asso-ciated illnesses. However, measuring and assessing a community or population's perceptions of body images with an acceptable level of accuracy can be difficult.12 The most reliable methods are very time, money, and labor intensive, as reflected in studies conducted by Thompson and Spana,13 which used subject-adjusted light beams to reflect body image perceptions, Gardner, et al.14 who used subject-adjusted TV-video images to reflect body image perceptions, or Smeets,15 who used a morphing instrument. In these techniques continuous measurements were obtained that allowed for accurate and unbiased results. However the difficulties associated with these techniques make them prohibitive, especially when one is trying to identify perceptions within large population groups or as part of epidemiological studies. Historically, silhouette matching tests (SMT) have been used to assess population body-image perceptions because of their ease of use.
Silhouette matching tests have been commonly used in studies to assess a group's body-image perceptions.16-19 Stunkard and his colleagues20 were the pioneers in this methodology and have continued to find SMT scales valid measures of body image.21 SMT reported in the literature typically...