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Validation of self‐reported obesity measurements from the Guam Youth Risk Behavior Surveillance System

In Guam, self‐reported body mass index (BMI) measurements are collected biennially from middle and high school students via the Youth Risk Behavior Surveillance (YRBS) survey. Additionally, actual BMI measurements are collected annually from all public school students via the Guam Department of Education (GDOE) BMI survey. The objective of this study was to compare the BMI classification in the YRBS to the GDOE BMI among high school students in Guam. The YRBS sample included 1,530 high school students and the GDOE BMI sample included 8,079 high school students. In both surveys, children were categorized by BMI percentiles into underweight (<5th percentile), normal weight (5th–84th percentile), overweight (85th–94th percentile), or obese (蠅95th percentile). The Pearson's chi‐squared test was used to compare BMI categories between the surveys. When comparing YRBS to GDOE BMI, the BMI categories were similar for underweight (3.7% versus 4.1%) and overweight (16.7% versus 16.2%). Normal weight was higher in the YRBS (64%) than in the GDOE BMI (58.1%) (P = 0.000), whereas obesity was lower in the YRBS (15.6%) than in the GDOE BMI (21.5%) (P = 0.000). The findings suggest that the YRBS is valid for estimating underweight and overweight, but not normal weight and obesity among Guam public high school students. Furthermore, obese high school students appear to be underreporting their BMI in the YRBS. Use of the Guam YRBS to estimate obesity among high school students should be done with precaution. Continuous support for the GDOE BMI survey is recommended to obtain optimal estimates of child obesity on Guam.