Protocol - Involuntary Weight Loss

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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:

Weight History


Publicly available

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 Needs
The 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.
Requirement CategoryRequired
Mode of Administration

Interviewer-administered questionnaire

Life Stage:


Adults aged 70-79 years at baseline

Specific Instructions:
Selection Rationale

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
Derived Variables


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

General References
Protocol ID:


Export Variables
Variable NameVariable IDVariable DescriptionVersiondbGaP Mapping
Research Domain Information
Measure Name:

Involuntary Weight Loss

Release Date:



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