How To Determine % Body Fat On A Male Using Pictures Or Drawings As A Reference

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Peer-reviewed

Research Article

Drawings or 3D models: Do analogy methods matter when assessing perceived body size and body dissatisfaction?

• Cynthia Sob,
• Luana Giacone,
• Kaspar Staub,
• Nicole Bender,
• Michael Siegrist,
• Christina Hartmann

10

• Published: December 21, 2021
• https://doi.org/10.1371/periodical.pone.0261645

Figures

Abstruse

Research has reported that both men and women experience torso dissatisfaction. Among other instruments, a widely used method to assess perceived body size and body dissatisfaction are effigy rating scales. Although a variety of illustration methods (eastward.m., three-dimensional, or 3D, models and line-drawing models) accept been used to create these figure rating scales, to appointment, they have not been directly compared to 1 some other. Thus, in the first study, which includes 511 participants at a mean historic period of 46 years erstwhile (range: xx–70), the present research work aims to appraise how the line-drawing and 3D model scales, representing different body illustration methods, relate to each other. Furthermore, the first written report assesses the validity of the indication of trunk dissatisfaction measured using these figure rating scales past comparing them to body checking or scrutinizing beliefs and body appreciation levels. The project's second study examines the two effigy rating scales using objectively measured anthropometric data. In full, 239 participants at a mean historic period of 54 years (range: 18–94) were included. The results show that effigy rating scales can be considered tools that measure perceptual body image due to their positive correlations with body checking beliefs (for women) and their negative correlations with torso appreciation. The 3D model and line-cartoon scales testify skilful to excellent inter-scale reliability, and both scales agree as well with trunk mass alphabetize (BMI) measurements. Thus, the 3D model and line-drawing scales both seem well suited for assessing perceived torso size and perceptual trunk dissatisfaction, suggesting that neither illustration method is superior to the other.

Citation: Sob C, Giacone L, Staub Thousand, Bough N, Siegrist M, Hartmann C (2021) Drawings or 3D models: Do illustration methods matter when assessing perceived body size and body dissatisfaction? PLoS One 16(12): e0261645. https://doi.org/10.1371/periodical.pone.0261645

Editor: Martin J. Tovée, Northumbria University Kinesthesia of Wellness and Life Sciences, U.k.

Received: December 9, 2020; Accustomed: December seven, 2021; Published: December 21, 2021

Copyright: © 2021 Sob et al. This is an open access commodity distributed under the terms of the Creative Commons Attribution License, which permits unrestricted utilize, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: https://osf.io/kh8vs/?view_only=cfe96ae2ace94e7eb2d0f4b3ac7d244f.

Funding: The authors received no specific funding for written report 1. Study 2 was supported by the Mäxi Foundation, Zurich. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

Introduction

A considerable number of men and women take reported existence dissatisfied with at least some parts of their bodies [1]. Body dissatisfaction is generally conceptualized as negative thoughts that a person fosters nearly their body [2], often in reference to body shape and size but also concerning more specific parts of the torso or facial features [3]. The last few years accept brought forth a selection of computerized and interactive tools to assess perceived and desired body size and shape [4–8]. Still, figure rating scales with pre-determined body illustration choices are still widely used and considered a time-saving and like shooting fish in a barrel-to-administrate method to assess cocky-ideal discrepancy as a proxy for body dissatisfaction [9, ten]. These scales are typically composed of various illustrations of the human body. Over the last few decades, a multitude of effigy rating scales have emerged that use different types of body illustration methods (see references [9, 11–xv] for a selection of instruments). These options prompt the question of whether 1 analogy method is superior to all others.

Figure rating scales assess self-reported perceived and desired trunk size via a fix of figures that range from very thin (or very lean) to very heavy (or very muscular). In accord with the cognitive-behavioral model of body image past Cash [3], these effigy rating scales mainly tap into the construct of torso paradigm perception. This perception is formed and determined through the specific historical and developmental circumstances a person has endured and requires the ability to adequately approximate one's advent in relation to a given reference. By calculating a self-ideal discrepancy score based on the figure ratings, information technology is possible to superficially infer participants' attitudes toward their body, meaning whether they are satisfied or dissatisfied with their body size. Nevertheless, it is important to note that it is not possible to assess body image investment—meaning the emotional, behavioral, and cerebral importance of a person's body self-evaluation—with these figure rating scales [3]. However, the discrepancy between perceived and desired body size tin can still be used for this purpose, and previous studies have indeed used it every bit an indication of body dissatisfaction [ix, 13, xvi].

While some effigy rating scales rely on illustrations based on line drawings [14, fifteen, 17], some researchers have used real-life photographs of female bodies [12]. Other figure rating scales rely on three-dimensional (3D) models [xi, thirteen], or computer-generated, biologically representative pictures, of male bodies to measure satisfaction (or dissatisfaction) with i's trunk size concerning fatness and muscularity [ix, 13]. For the purposes of the present written report, the focus lies on the Profile Cartoon Rating Scale based on line-drawing figures by Thompson and Grey [14] and 3D figures from the Body Dissatisfaction Calibration by Mutale et al. [11], which are introduced in more detail below. In this written report, the Contour Drawing Rating Scale [14] is referred to as the line-drawing calibration and the Body Dissatisfaction Scale [11] as the 3D model scale.

Body image research has used figure rating scales to appraise perceptual body dissatisfaction inside various written report samples, ranging from college students to big-scale international population-based samples [9, 18–21]. Although these figure rating scales seem to be applied, easy-to-utilise, easy-to-administer, and time-saving assessments, they take faced criticism. Figure rating scales based on line-drawing figures by artists—such as the line-cartoon scale [14]—accept especially been criticized for appearing unrealistic and disproportionate, involving size-difference inconsistencies between the illustrated figures [22, 23]. Furthermore, the line-drawing scale has been criticized for its disproportionate arm and leg lengths and thicknesses, as well every bit its lack of separation betwixt the arms and the rest of the body, which appears to be problematic for obese figures [11]. These problems might potentially make it more difficult for participants to identify themselves with one specific figure on the scale.

To address this inconsistency in body size illustrations amidst both male and female figure rating scales, the 3D model scale—a computer-generated figure rating scale—was developed [eleven]. Information technology comprises 3D models of both men and women, using the same body measurements for either sex (eastward.g., the same leg and arm lengths) and metrically proportional increases in body weight and size. This scale'southward measurements are based on calculated trunk mass index (BMI) values from 3D-generated trunk heights and volumes [11]. The 3D model calibration might represent body sizes more fairly because its development considered BMI as an anthropometric measurement. Nevertheless, a limitation might be that the 3D models wear black clothing that could obscure important features and cues of the body that indicate adiposity or muscularity [24–26].

Although figure rating scales might lack particular compared to text-based cess tools, especially regarding body prototype investment, previous enquiry has shown that body dissatisfaction assessed with figure rating scales is associated with text-based tools that assess body image [11, 12, 16, 27]. One such tool is the Body Appreciation Scale [28], which measures appreciation and credence of one's body despite internal or external negative influences. One report showed that the Torso Appreciation Calibration is negatively correlated with the 3D model scale for both women (r = -.60, p < .001) and men (r = -.46, p < .001) [11]. Moreover, another study institute that the line-drawing scale [14] had a significantly positive correlation with a subscale of the Eating Disorder Inventory measuring trunk dissatisfaction among adolescent girls [16]. Thus, in agreement with previous studies, the perceived–desired body image discrepancy assessed via figure rating scales can be considered a proxy to assess body dissatisfaction [nine, 11, 16].

To further demonstrate the construct validity of perceived body size as assessed through effigy rating scales, the about unremarkably used anthropometric parameter is BMI [11–fourteen]. Validation study results have shown that BMI positively correlates with figure rating scales, with r = .59–.83 for self-reported BMI [11, 12, xiv] and r = .69–.82 for objectively assessed BMI [13, 16]. Some studies have used other anthropometric measures also, such equally waist circumference, torso fat pct, and fat-free mass [13, 17].

In summary, to date, a multitude of effigy rating scales have been developed and validated; however, to the best of the researchers' knowledge, no study has examined these effigy rating scales directly with the purpose of comparing their illustration methods. This simultaneous examination of the line-cartoon and 3D model scale is important because, referring to their illustration method, one scale might be preferable over the other. Furthermore, these figure rating scales have not been tested equally for men and women: such tests have often included more young female participants as a event of student convenience sampling [11, 14, xvi]. Therefore, the present research piece of work's principal aim, through its first study, was to compare two figure rating scales that apply line drawings or 3D models as analogy methods using a population-based and historic period-various sample, and to assess their link to text-based tools that mensurate body image components. The line-cartoon and 3D model scales were specifically selected because, on the one manus, they correspond different styles of trunk analogy methods and, on the other hand, they were developed in different decades. This presents an interesting context in which to explore whether older scales—such as the line-drawing scale—can compete with newer scales—such as the 3D model scale. The text-based body image cess tools were the Trunk Appreciation Scale [28] for both sexes, the Torso Checking Questionnaire for women [29], and the Male person Torso Checking Questionnaire for men [30]. The two latter tools were selected because body scrutinizing or checking behavior can be used equally behavioral indications of body dissatisfaction through excessive attention to trunk weight or shape [29, xxx].

Through Study 2, this project's second aim was to examine age-diverse participants' perceived body size as assessed through the ii effigy rating scales in relation to objectively measured anthropometric information to farther contribute to the figure rating scales validation literature. To this end, BMI, body fat percentage, and waist circumference were chosen equally considerately measured information for comparison to the figure rating calibration assessments [12], thus overcoming self-reporting bias in anthropometric data. Furthermore, BMI was selected as the anthropometric reference measure to assess its level of understanding with the figure rating scales, particularly every bit the 3D model scale's computer-generated models are based on calculated BMI values [11]. Moreover, to appointment, BMI is even so considered a relevant measure to determine thresholds for elevated disease risks such every bit diabetes, hypertension, and other cardiovascular illnesses [31].

Thus, these 2 studies aimed to fill the research gap regarding the comparison of figure rating scales' illustration methods. This overall projection investigated the figure rating scales' stance inside trunk epitome enquiry and their link to considerately measured anthropometric data to make statements nigh whether i illustration method is superior to the other.

Study 1

Comparing the line-cartoon scale [14] and 3D model calibration [11] with one another, body checking behavior, and trunk appreciation is important to assess their validity. Accordingly, the two figure rating scales and their level of understanding were compared to analyze their relationship with each other. Based on previous research [eleven, 12] that found negative correlations between trunk appreciation and body dissatisfaction as measured by figure rating scales, the researchers expected to find the same negative relationship betwixt trunk dissatisfaction measured using the figure rating scales and the Body Appreciation Scale for both sexes. Additionally, the researchers expected a college frequency of body checking behavior to exist positively associated with body dissatisfaction as measured with the figure rating scales.

Methods

Participants and procedure

The information collection took place via an online survey in May 2019. The participants were recruited in the German-speaking part of Switzerland from a commercial sampling service provider's net panel (Respondi AG). Quota samples were used for age and sexual activity. Before starting with the questionnaire, participants were presented with the written report information on the screen where they had to give their consent. Respondents were excluded from the report if they did not complete the survey (n = 25) or if their total survey duration was less than half of the median total survey duration (n = 26, median = nine.three minutes). Additionally, meaning women (n = iii) and participants without a articulate gender classification (due north = 1) were excluded. The study's concluding sample consisted of 511 participants. The mean age of the sample was 46 years (SD = xiv). The mean BMI was 25.5 kg/1000^two (SD = 6.iii) for women and 26.0 kg/thou^two (SD = 4.4) for men. Tabular array 1 provides further participant socio-demographic information.

Measures

Figure rating scales.

Perceived body size and desired torso size were assessed using two different trunk scales per sex. The line-drawing calibration [14] and the computer-based 3D model calibration [eleven] each included nine body figures. Both male and female person versions of these scales were available (encounter Fig 1 for illustrations of the effigy rating scales).

Fig ane. Illustrations of the used figure rating scales.

(a) The line-drawing scale [xiv] with female figures in the offset row and male figures in the second row. (b) The 3D model scale [11] with female figures in the kickoff row and male person figures in the second row. These figures are presented from left to correct in ascending lodge, from very thin to very heavy.

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The participants were asked to select the body figure that best reflected their perceived body size and desired body size. They were first presented with the respective effigy rating scales with the instructions for perceived body size ("Please select the analogy that looks well-nigh like you"), followed by the instructions for desired torso size ("Delight select the illustration you nearly desire to wait similar"). All figures were presented simultaneously in ascending order from left to right, from (1) very thin to (9) very heavy. Torso dissatisfaction was calculated using the difference betwixt the participants' perceived and desired body size. A positive score indicated that participants preferred a thinner body size, whereas a negative score indicated that they preferred a larger body size.

Torso appreciation.

To appraise torso appreciation level, this written report utilized a German translation of the Body Appreciation Scale [28]. Information technology features 13 items measuring four aspects of positive body epitome: favorable opinions of the body, respect for the body, acceptance of the body, and protection of the trunk. Case items include "Despite its imperfections, I still like my torso" and "I do not focus a lot of energy being concerned with my body shape or weight." One particular was slightly modified to accost both male person and female participants ("I do not allow unrealistic images of women/men presented in the media to impact my attitudes toward my body"). The items were scored on a 5-point scale from 1 (never) to 5 (always). A mean score was and then calculated from them, with higher scores indicating higher levels of body appreciation. The Cronbach'southward alpha was α = .92.

Female person body checking beliefs.

The High german version [32] of the 23-item Body Checking Questionnaire [29] was used to appraise female person body checking beliefs. The items were rated on a 5-signal scale, ranging from 1 (never) to five (very often). Questionnaire items included "I touch on underneath my chin to brand sure I don't take a double chin," "I check to encounter how my bottom looks in the mirror," and "I bank check to see if my fat jiggles." A higher sum for these scores indicated a higher frequency of female body checking behavior. The Cronbach's alpha was α = .93.

Male body checking behavior.

For male participants, a German translation of the Male Torso Checking Questionnaire [30] was used. It incorporated specific items formulated for men relating to muscle mass, reduced subcutaneous torso fat, and the shape or feel of specific muscles. Questionnaire items included "I will check the size and shape of my muscles in most reflective surfaces" and "I ask others to experience my muscle to ensure their size or density." The questionnaire's 19 items were scored on a 5-point Likert calibration from 1 (never) to 5 (very often). A college sum-score indicated a higher frequency of male person body checking behavior. The Cronbach's alpha was α = .95.

Sociodemographic data.

The participants were asked to bespeak their age, sexual activity, educational level, vocational status, pinnacle in centimeters, and weight in kilograms. The ii latter data points were used to calculate self-reported BMI by dividing weight in kilograms by tiptop in foursquare meters (kg/m²).

Statistical analyses

Outlier BMI analyses were conducted to reveal extreme BMI values. Even though severe over- or underweight body types might be indicative of underlying health problems [33], the researchers decided to include these participants within the written report because these values are biologically plausible, and the figure rating scales aim to assess both under- and overweight body types. Every bit a precaution, the participants with extremely low BMI values were temporarily removed to conduct all analyses. It was decided to not exclude them from the dataset because they did non considerably influence the results. To examine links between perceived and desired body size in the two figure rating scales, Pearson's correlation coefficients were calculated. Agreement betwixt the 3D model and line-drawing scales for perceived and desired body sizes were calculated with intra-class correlation (ICC) estimates and 95% confidence intervals (95% CI) based on single-rating, accented-agreement, 2-style mixed-furnishings models [34, 35]. To interpret the ICC values, the 95% CI were considered [34]. To appraise the validity of the body dissatisfaction measured by the figure rating scales, Pearson's correlation coefficients were calculated with cocky-reported BMI, body checking behavior, and body appreciation levels; all analyses were conducted separately for men and women. Pearson correlations were compared to Spearman rank correlations, and both methods immune the same conclusions. Therefore, Pearson correlations alone were presented. R version 4.0.2 [36] was used for these analyses with the following packages:, psych [37], tidyverse [38], ggpubr [39], sjPlot [forty], and irr [41].

Results

Associations between the figure rating scales and BMI

Pearson's correlation coefficients were calculated to appraise the relationships betwixt perceived torso size and desired body size in the 3D model and line-drawing scales for both sexes. The results show that for both sexes' perceived and desired body sizes, strong positive correlations existed between the 3D model and line-cartoon scales (perceived body size—men: r = .88, p < .001; perceived torso size—women: r = .92, p < .001; desired body size—men: r = .seventy, p < .001; desired trunk size—women: r = .84, p < .001). This means that both figure rating scales are indeed highly related. Fig 2 shows scatterplots illustrating these correlations. Additionally, the BMI values calculated from the participants' self-reported weight and acme bear witness loftier positive correlations with perceived body size as assessed past the two effigy rating scales for men (3D model scale: r = .73, p < .001; line-drawing scale: r = .70, p < .001) and women (3D model scale: r = .78, p < .001; line-drawing scale: r = .76, p < .001). Thus, self-reported BMI seems to exist similarly linearly associated with both figure rating scales for men and women.

Fig 2. Scatterplots showing the correlations between the line-cartoon scale (y-axis) and 3D model scale (x-axis).

The different sizes of the greyness dots stand for the number of participants who chose the same figures on the figure rating scales. The dashed line represents a perfect correlation between both scales. (a) Male perceived body size; (b) male person desired body size; (c) female perceived body size; (d) female desired body size.

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Agreement between the figure rating scales

Levels of understanding between the line-drawing and 3D model scales were analyzed using ICCs and their 95% CI based on single-rating, absolute-agreement, 2-way mixed-effects models [34, 35]. Per Fig three, the results for men show that the ICC between the 3D model and line-drawing scales for perceived body size (ICC = .85, 95% CI = [.72, .91]) indicate moderate to excellent inter-scale reliability, and the ICC for the corresponding figure rating scales for desired body size (ICC = .68, 95% CI = [.59, .76]) testify moderate to good inter-scale reliability. For women, the ICC value betwixt the 3D model and line-cartoon scales for perceived torso size (ICC = .92, 95% CI = [.90, .94]) indicate excellent inter-calibration reliability, while the ICC for the corresponding figure rating scales for desired body size (ICC = .84, 95% CI = [.80 .87]) show good inter-calibration reliability. Thus, both effigy rating scales similarly demonstrate how the participants chose their perceived and desired torso sizes, despite potentially involving more than discrepancy between scales regarding desired trunk size choices for both sexes.

Fig 3. Level of understanding between figure rating scales.

The intraclass correlation (ICC) values and confidence intervals (CI) for perceived trunk size and desired torso size between the 3D model and line-drawing scales are besides shown for (a) men and (b) women.

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Associations betwixt body dissatisfaction measured by the figure rating scales, torso appreciation, torso checking behavior, BMI, and age

Separate Pearson's correlation coefficients were calculated for the two figure rating scales, cocky-reported BMI, body appreciation levels, and body checking beliefs for both sexes (Tables 2 and three). For women, self-reported BMI correlates positively with body dissatisfaction measured using the two body figure scales (3D model scale: r = .46, p < .001; line-drawing scale: r = .47, p < .001). Similar results exist for men, where both scales are positively correlated with self-reported BMI (3D model scale: r = .54, p < .001; line-drawing scale: r = .49, p < .001). Thus, for both sexes, body dissatisfaction levels measured with the selected figure rating scales increase with higher self-reported BMI. Furthermore, for women, the results show medium-to-large negative correlations betwixt body appreciation levels and body dissatisfaction measured with the ii effigy rating scales (3D model calibration: r = -.43, p < .001; line-cartoon scale: r = -.fifty, p < .001). For men, modest negative correlations are observed between the effigy rating scales and body appreciation levels (3D model scale: r = -.xviii, p < .001; line-drawing calibration: r = -.20, p < .001). Thus, these results ostend previous findings [11, 12] of negative correlations betwixt body appreciation and body dissatisfaction.

Tabular array 2. Pearson correlation coefficients between body dissatisfaction measured with the figure rating scales (3D model scale, line-cartoon scale), body appreciation levels, body checking behavior, torso mass index (BMI), and age for men (northward = 245).

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Table 3. Pearson correlation coefficients between trunk dissatisfaction measured with the figure rating scales (3D model scale, line-drawing scale), body appreciation levels, body checking behavior, body mass alphabetize (BMI), and age for women (north = 266).

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Additionally, female body checking behavior positively correlates with body dissatisfaction measured with the effigy rating scales for women (3D model scale: r = .24, p < .001; line-drawing scale: r = .28, p < .001). Meanwhile, for men, there is a small-scale negative correlation between male body checking behavior and the 3D model scale (r = -.15, p < .05) and no pregnant correlation with the line-drawing scale (r = -.07, p > .05). Thus, while body checking behavior correlates with body size dissatisfaction measured past the figure rating scales for women, this link is inverse or not present for men.

Discussion

The nowadays written report demonstrates the validity of two easy-to-administer and time-saving effigy rating scales to assess perceived and desired body size, and its use equally a proxy to assess perceptual trunk size dissatisfaction within an historic period-diverse sample.

The 2 figure rating scales—the 3D model and line-cartoon scales—showed loftier positive intercorrelations for both sexes. These results applied to perceived body size and desired body size. Additionally, the level of agreement between the two figure rating scales featured good-to-splendid reliability in perceived body size and moderate-to-good reliability in desired body size, meaning both effigy rating scales seem equally well suited for participants to rate their perceived body size. Slightly more variation emerged between the figure rating scales regarding desired body size choices.

In accordance with previous findings [11, 12, 16], the present report found significant negative correlations for both sexes between body dissatisfaction measured with the ii effigy rating scales and torso appreciation. Correlations were slightly weaker for males than for females. One possible explanation could exist that the first version of the Body Appreciation Calibration [28] was used in the nowadays study, which has only been validated with a female sample. Even though previous studies, such as Mutale et al. [11], accept used the first version of the Trunk Appreciation Scale to validate their effigy rating scale for both sexes, futurity research should consider using the Trunk Appreciation Scale-2 [42], which includes a revised detail selection and has been validated for men equally well as women.

Significant positive correlations with body checking beliefs also emerged for women and inverse to no correlations for men. This finding might exist explained by the Male Body Checking Questionnaire's stronger focus on muscularity, muscle mass, and shape [30], while body size dissatisfaction assessed with the male person 3D model and line-cartoon scales concerns body fat distribution and thin-ideal fat-related body dissatisfaction instead. (To make the present research more concise and focused on the thin-ideal and fat-related body dissatisfaction, the researchers decided not to nowadays the negative correlation (r = -.20, p < .01) betwixt body dissatisfaction measured by a effigy rating scale on male muscularity [13] and male body checking behavior [30]). Thus, given these meaning correlations, the 3D model scale and line-drawing calibration can be considered valid to address sparse-platonic and fatty-related perceptual trunk dissatisfaction, particularly for women.

Nevertheless, the present written report featured a bias risk because of its reliance on self-reported data, specially concerning cocky-reported weight among overweight participants [43, 44]. Nonetheless, contempo studies have demonstrated that the correlation between cocky-reported weight and measured weight is sufficiently loftier [45] and, thus, BMI computed from self-reported weight and height represents a valid measure for both men and women [46]. Further general limitations regarding both studies are addressed after in the General Give-and-take section.

In conclusion, the 3D model and line-drawing scales can be used interchangeably every bit easy-to-administer and fourth dimension-saving assessments of perceived body size and judge perceptual trunk dissatisfaction.

Report two

A second report was conducted to overcome Study 1's limitations concerning self-reported weight and meridian to calculate BMI. In addition to BMI, waist circumference and trunk fat percentage were selected as objectively measured anthropometric information. Thus, Study two aimed to investigate the links between the participants' responses regarding perceived trunk size in the 3D model and line-cartoon scales with measured BMI, trunk fat percent, and waist circumference. Furthermore, the figure rating scales' agreement with measured BMI were assessed. The researchers expected that both effigy rating scales would positively correlate with the anthropometric measures. The analyzed level of agreement betwixt the scales and measured BMI further elucidated whether one illustration method is superior.

Methods

Participants

The participants were recruited through written invitations (Swiss Food Panel 2.0 participants [47–52]) via mailing lists from science communication events and through media advertisements. To exist included in the study, participants had to be at least eighteen years of historic period and have a adept understanding of the German language. The initial sample consisted of 241 participants. For the nowadays report's purposes, currently meaning participants (n = two) were excluded. The last sample included 239 participants. The sample'south mean age was 54 years (SD = 19). The mean BMI was 23.1 kg/m² (SD = three.i) for women and 25.5 kg/thousand² (SD = iii.v) for men. Missing values were addressed separately within the unlike analyses. Table 4 shows the sample demographics.

Process

The participants were given written data containing the study procedure clarification and their rights followed by an informed consent form, which had to be signed prior to participation. As a outset step, the participants responded to an in-house paper-and-pencil questionnaire containing the 3D model and line-drawing scales, as well equally demographic questions regarding other measures. Additional measures were assessed but are not part of the nowadays study and thus not further described. Next, the participants were asked to enter an exam room, where their anthropometric measurements were taken. They were asked to change into skin-tight vesture, which they had brought themselves, or strip downwardly to their underwear. The participants then underwent bioelectrical impedance analysis (BIA) to appraise their trunk composition. Post-obit these measurements, the participants put back on their regular clothing they had arrived in. This study was canonical by the Ethics Committee of ETH Zurich (EK 2019-N-08).

Measures

Anthropometric measurements.

A medical 8-indicate body limerick analyzer (Seca mBCA 515, Seca AG, Reinach, Switzerland) was used to determine the participants' total trunk fat pct, among other torso composition factors. The device has been validated in several studies and is often used to compare torso composition measures obtained through various measurement methods [53–55]. For this BIA measurement, the participants were instructed to stand up barefoot on the device's four foot electrodes and place both hands on the four hand electrodes.

To assess their body height, the participants had to stand upright in their underwear or pare-tight clothing on a standard stadiometer (Seca 274) for measurement. Meridian information were transferred to the body composition analyzer (Seca mBCA 515), where the participants' weight was measured. The device so calculated the participants' BMI.

During the BIA measurements, manual waist circumference measurements were obtained according to World Health Organization (WHO) protocol [31] with a paw-held, stretch-resistant record with automatic retraction (Seca 201). These measurements were taken by trained and experienced research personnel at the midpoint between the lowest point of the ribcage and the highest point of the pelvis.

Perceived body size.

To appraise perceived body size, ii figure scales were used: the 3D model scale [11] and the line-drawing scale [14]. The related assessment is described above in the Methods section of Written report ane.

Statistical analyses

The same outlier analyses were conducted with the anthropometric information (BMI, body fat percentage, and waist circumference). Even though one distributional BMI outlier was detected, the researchers decided non to exclude this participant from the sample for the same reasoning every bit in Study one. To examine the links between perceived torso size using the figure rating scales and anthropometric measurements (BMI, body fat percent, and waist circumference), Pearson's correlation coefficients were calculated. Understanding betwixt the figure rating scales and measured BMI were calculated using two-way mixed-effects, absolute-agreement, unmarried-rater intra-grade correlations (ICC3, 1) [34]. To ensure comparability between objectively measured BMI and the two figure rating scales, the scores were transformed into standardized z-scores for the ICC analyses. All analyses were conducted separately for men and women. As Pearson product-moment and Spearman rank correlations allowed the same conclusions, Pearson's r lonely was presented. The same R version and packages were used as in Written report i.

Results

Associations between perceived torso size assessed by the figure rating scales and anthropometric measures

To measure the relationships betwixt the perceived torso size assessed by the 3D model scale scores (range: ane–9), line-drawing scale scores (range: 1–9), and anthropometric measures, Pearson's correlations were calculated. The results evidence that both scales correlate positively with BMI, total torso fatty percent, and waist circumference. High positive correlations also emerged between BMI, waist circumference, and body fat per centum and both figure rating scales for both sexes (Tables v and 6). Fig 4 illustrates these correlations for both figure rating scales.

Fig 4. Boxplots illustrating the correlations between the figure rating scales and anthropometric measurements.

The measurements of (a) body mass index (BMI), (b) relative body fat, and (c) waist circumference in centimeters are depicted by sexual practice.

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Table 5. Descriptive statistics and Pearson correlation coefficients between perceived body size assessed with the figure rating scales and anthropometric measurements for men (n_max = 128, n_min = 122).

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Table 6. Descriptive statistics and Pearson correlation coefficients betwixt perceived body size assessed with the figure rating scales and anthropometric measurements for women (n_max = 111, n_min = 107).

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Agreement and comparison between perceived body size assessed by the figure rating scales and measured BMI

In accordance with Study 1's findings, the agreement levels between the 3D model and line-drawing scales for perceived body size indicate expert inter-scale reliability for men (ICC = .80, 95% CI = [.60, .89]) and good-to-first-class inter-scale reliability for women (ICC = .86, 95% CI = [.80, .91]).

Understanding for men between the 3D model calibration and measured BMI shows moderate-to-good inter-mensurate reliability (ICC = .69, 95% CI = [.l, .lxxx]), while the ICC betwixt the line-drawing calibration and measured BMI shows moderate inter-measure reliability (ICC = .65, 95% CI = [.53, .74]). The results for women show that the ICC between the two scales and measured BMI (3D model calibration: ICC = .71, 95% CI = [.49, .84]; line-drawing scale: ICC = .69, 95% CI = [.58, .78]) indicates moderate-to-good inter-scale reliability (Fig 5). Thus, considering in that location is an overlap of the 95% CI between the two scales for both sexes, both scales seem to depict perceived body size equally well co-ordinate to BMI.

Fig 5. Level of agreement between body mass index (BMI) and the figure rating scales.

This plot includes intraclass correlation (ICC) values and 95% confidence intervals (CI) for assessing agreement levels between BMI and the 3D model scale, besides as BMI and the line-drawing scale, for (a) men and (b) women.

https://doi.org/10.1371/journal.pone.0261645.g005

Discussion

Study ii showed that the 3D model scale and the line-drawing scale both highly correlate with anthropometric measurements. This finding demonstrates that both effigy rating scales are equally well suited as instruments for assessing perceived body size. Consistent with the results of Study one, Report ii also showed that both scales feature high understanding. Furthermore, high positive correlations for both sexes emerged between both scales and BMI, body fat pct, and waist circumference. The highest positive correlations were found for measured BMI. These findings marshal with previous studies that used measured and cocky-reported BMI equally validation methods [eleven–13, sixteen, 17]. The effigy rating scales were then compared in more particular to measured BMI to assess agreement levels between the measurement techniques. These results showed that both scales are equally well suited to guess BMI measurements, with moderate-to-expert inter-measurement reliability.

Even so, some limitations specific to Study 2 demand to be addressed. First, although total trunk fatty percentage and BMI were assessed using a precise BIA device and built-in stadiometer and calibration, pocket-size technical or calibration measurement errors might notwithstanding accept occurred. Because all participants were measured using the same device, and considering BIA validation was non amongst the present report's goals, these potential errors should non have influenced the study'southward overall data quality. Second, although waist circumference measurements were obtained by trained personnel according to strict WHO protocol, marginal inter-observer differences could have occurred between measurements [56]. Finally, the last limitation is that the study's sample size was rather small. However, similar relationships would be expected in dissimilar and larger samples.

In determination, both the 3D model calibration and the line-drawing scale were observed to exist every bit well suited and valid instruments for assessing perceived body size with regard to anthropometric measurements, especially measured BMI.

Full general discussion

The present research highlighted the correlations and agreement levels between figure rating scales, text-based body image instruments, and anthropometric measurements. First, the results of Written report 1 showed high intercorrelations and understanding for perceived and desired trunk size among the 3D model and line-drawing scales for both sexes. Second, body dissatisfaction assessed with the two figure rating scales showed similar correlations with body appreciation and body checking beliefs for women. For men, torso checking behavior correlated negatively with the 3D model calibration and not at all with the line-cartoon scale. Overall, this ways that both figure rating scales can perhaps be used interchangeably to assess perceived and desired trunk size, too as to summate judge perceptual body dissatisfaction. Third, the 2 effigy rating scales proved equally well suited in representing objectively measured anthropometric data in Study 2. These results showed that the 3D model and line-cartoon scales tin exist used interchangeably to appraise perceived body size and trunk dissatisfaction within age-diverse, population-based report samples, with no analogy method superior to the other. These findings are important, as they emphasize that the line-drawing calibration, though older and apparently less precise, does non seem significantly less adequate than the 3D model scale. This finding holds true for both sexes and beyond the two unlike samples from Studies i and 2.

Nonetheless, the present research has some limitations regarding both studies. First, at the individual level, the participants faced a risk of misclassifying their perceived body size due to body size misconceptions or underlying psychological conditions [57]. Still, considering the incidence of such conditions in a severe form is quite minor, the number of potentially concerned participants was considered small as well. 2d, all figures within the figure rating scales were presented in ascending social club (from very thin to very heavy) adjacent to each other, and both figure rating scales were presented presently after i another. This might have caused the participants to remember the location of the figure they chose on the first scale and suit their following choices accordingly. Lastly, the findings present limited generalizability to white populations, and the wide age ranges within the samples might have influenced the results.

For future studies, information technology might be of interest to compare other analogy methods (due east.g., realistic vs. stylized figures) and vary the presentation order of the figures to ensure more independent figure ratings betwixt scales. It might also be of interest to compare forced choice figure rating scales with recently adult laboratory-based computerized body size interpretation and dissatisfaction tasks [4–viii].

In conclusion, the 3D model calibration and line-drawing scales tin be used interchangeably to assess perceived body size and perceptual trunk dissatisfaction in an easy-to-administer and time-saving manner. These findings show that the body illustration method (line drawings or 3D models) within these figure rating scales might non make much of a difference for participants to indicate their perceived torso size and assess trunk dissatisfaction. Thus, both figure rating scales could exist used interchangeably in big-scale, population-based studies equally quick assessments of perceived torso size and approximate perceptual body dissatisfaction.

Acknowledgments

The present authors would like to thank all participants for their contribution to this study and all research squad members for their support. We also thank G. Limacher, Due south. Güsewell, and Yard. Matthes for their support with the participant assistants, information acquisition, and data preparation.

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