Can body mass index predict percent body fat and changes in percent body fat with weight loss in bariatric surgery patients?

The primary objective of this study was to assess the validity of body mass index (BMI) in predicting percent body fat and changes in percent body fat with weight loss in bariatric surgery patients. Twenty-two bariatric patients (17 female, five male) began the study designed to include 12 months of testing, including data collection within 1 week presurgery and 1 month, 3 months, 6 months, and 1 year postsurgery. Five female subjects were lost to the study between 6 months and 12 months postsurgery, resulting in 17 subjects (12 female, five male) completing the 12 months of testing. Variables measured in the study included height, weight, percent fat (% fat) by hydrostatic weighing, lean mass, fat mass, and basal metabolic rate. Regression analyses predicting % fat from BMI yielded the following results: presurgery r = 0.173, p = 0.479, standard error of estimate (SEE) = 3.86; 1 month r = 0.468, p = 0.043, SEE = 4.70; 3 months r = 0.553, p = 0.014, SEE = 6.2; 6 months r = 0.611, p = 0.005, SEE = 5.88; 12 months r = 0.596, p = 0.007, SEE = 7.13. Regression analyses predicting change in % fat from change in BMI produced the following results: presurgery to 1 month r = -0.134, p = 0.583, SEE = 2.44%; 1-3 months r = 0.265, p = 0.272, SEE = 2.36%; 3-6 months r = 0.206, p = 0.398, SEE = 3.75%; 6-12 months r = 0.784, p = 0.000, SEE = 3.20. Although some analyses resulted in significant correlation coefficients (p < 0.05), the relatively large SEE values would preclude the use of BMI in predicting % fat or change in % fat with weight loss in bariatric surgery patients.