BACKGROUND: Obtaining abdominal adiposity through self-reporting of body silhouettes could be a tool in long-distance epidemiological studies. OBJECTIVE: To determine the cut-off point of body silhouettes and evaluate their diagnostic certainty in the classification of abdominal adiposity in Mexican adolescents. MATERIAL AND METHODS: An analytical cross-sectional study was carried out on adolescents aged 14 to 18, high school students in the State of Mexico. The participants signed the informed consent, a body silhouette (BS) scheme was applied and their waist circumference (WC) was measured at the abdominal midpoint. Descriptive analyzes were performed, the best cut-off point was determined using ROC curves and the Youden index, and the diagnostic performance of BS to identify abdominal adiposity was evaluated. RESULTS: 513 students were included (57% female
median age 16 [IQR 15-17] years). BS 6 was found to be the best cut-off point for both women (Youden = 0.68) and men (Youden = 0.69). The sensitivity was 91% in women and 79% in men, the specificity was 77% in women and 89% in men, with a positive likelihood ratio of 3.92 (95%CI = 3.77, 4.08) for women and 7.08 ( 95%CI = 4.55, 11.0) for men. CONCLUSIONS: Self-reported BS are a tool with high certainty that can be used to discriminate abdominal adiposity in adolescents.