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1/11(14),20 2011. A previous study using a validated tool, the DDS, for measuring height, weight, and body mass index was conducted at the HMO and was reported to have similar validity to the DDS.20 The DDS is a 20-question instrument that asks a participant to rate their height and weight on a scale from 1 (not at all) to 5 (extremely) and their body mass index (BMI—or percentage of body fat) on a 100-cm visual analog scale from 0 [at or below ideal body weight] to 19 [at or above ideal body weight]. The DDS is also valid on a scale from 0 to 2, representing healthy weight and normal weight, respectively. The instrument has been used extensively in epidemiological studies by evaluating measures of anthropometric measurements and metabolic variables, such as systolic blood pressure and fasting or postprandial serum glucose. For example, the DDS has been used to determine whether certain factors are risk factors in human health.20 The authors of the current study also used the DDS to evaluate trends in obesity among children.20 They concluded that the DDS was valid and reliable, and demonstrated that the prevalence of overweight children at the HMO was less than in previously published studies in the United States.20 The reasons for these and other inconsistencies among studies of childhood obesity that has been reported in the literature were discussed in detail by Genre et al. in a paper entitled “The role of the prevalence of eating disorders in health care: An introduction” published in The International Journal of Eating Disorders in 2005.20 Some authors stated that in order for an outcome to be classified as an eating disorder, clinical criteria of restriction and disinhibition must be present and be persistent, whereas in other studies, they were not.20 One of the differences between the studies cited is that some studies used the International Index of Erectile Function (FIEF) to evaluate the scores of the patients to estimate their level of obesity.20 In the Genre et al. study, investigators examined the prevalence of eating disorders among 2,764 children diagnosed with an eating disorder compared with 2,566 matched controls who never had an eating disorder.20 They found that a higher percentage of male and female adolescents with eating disorders had a history of childhood and puberty-related stressors than matched controls.20 However, the DDS had different results. Based on the DDS, Genre et al.

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