Protocol - Involuntary Weight Loss
An interviewer-administered two-item questionnaire assessing weight loss of more than five pounds in the past 12 months and an individual's intent to lose weight.
1. Have you lost 5 or more pounds at any time over the past 12 months?
[ ] 1 Yes (if yes, go to 1b)
[ ] 0 No (go to question 2)
[ ] 8 Don't know (go to question 2)
[ ] 7 Refused (go to question 2)
1b. How much weight did you lose in the past 12 months? If you are not sure, please make your best guess.
[ ] ___ ___ ___ pounds
[ ] 8 Don't know/don't remember
[ ] 7 Refused
2. Were you trying to lose weight?
[ ] 1 Yes (go to question 2b)
[ ] 0 No (go to question 3)
[ ] 8 Don't know (go to question 3)
[ ] 7 Refused (go to question 3)
2b. What methods did you use to lose weight?
[ ] -1 Reduced food intake (decreased quantities of all food eaten)
[ ] -1 Limiting your intake to only 1 or 2 types of food (e.g., ate only grapefruit or only lean meats)
[ ] -1 Reduced fat intake
[ ] -1 Use of fat/caloric modified foods (low fat, fat-free)
[ ] -1 Use of a liquid diet formula such as Slim-fast or Optifast
[ ] -1 Commercial weight loss program (Weight Watcher, Jenny Craig, or self-help group (Over Eaters Anonymous, TOPS)
[ ] -1 Decreased alcohol intake
[ ] -1 Increased exercise
[ ] -1 Increased smoking
[ ] -1 Diet pills (prescription or nonprescription)
[ ] -1 Stomach surgery/intestinal bypass
[ ] -1 Consulted with dietician/physician/other professional
[ ] -1 Other (Please specify): _______________________
3. What do you think caused this weight loss? (Interviewer note: Please check all that apply)
[ ] -1 Illness (please specify): _____________
[ ] -1 Surgery (please specify): ____________
[ ] -1 Medications
[ ] -1 Stressful time
[ ] -1 Loss of appetite
[ ] -1 Change in eating habits
[ ] -1 Change in exercise habits/amount of physical activity
[ ] -1 Other (please specify): _______________________
[ ] -1 Don't know
Protocol Name from Source:
Personnel and Training Required
The interviewer must be trained to conduct personal interviews with individuals from the general population. The interviewer must be trained and found to be competent (i.e., tested by an expert) at the completion of personal interviews. The interviewer should be trained to prompt respondents further if a "don't know" response is provided.
Equipment NeedsThe PhenX Working Group acknowledges that these questions can be administered in a computerized or noncomputerized format (i.e., paper-and-pencil instrument). Computer software is necessary to develop computer-assisted instruments. The interviewer will require a laptop computer/handheld computer to administer a computer-assisted questionnaire.
Mode of Administration
Adults aged 70-79 years at baseline
These questions were used in the Health, Aging, and Body Composition Study, and recognized as making a valuable contribution to the study of body composition and strength in old age and how these changes relate to an individual's health and disability.
|Common Data Elements (CDE)||Weight History Questionnaire Assessment Score||6360515||CDE Browser|
Process and Review
The Expert Review Panel has not reviewed this measure yet.
Health, Aging, and Body Composition Study, Weight History, Question 52 and 52b version 1.1a 8/22/97
|Variable Name||Variable ID||Variable Description||Version||dbGaP Mapping|
Involuntary Weight Loss
A questionnaire assessing involuntary weight loss in the past 12 months.
Involuntary weight loss is a common problem in the geriatric population and is associated with diseases, frailty, disability, and an increased risk of mortality. It is important not only to identify weight loss but also to assess whether the weight loss was intentional (did the patient try to lose weight) or unintentional (occurring without any effort to lose weight).
Health, Aging, and Body Composition Study, Health ABC, geriatrics, National Institute on Aging, NIA, weight change, gerontology, aging