Waist Circumference

Carrying fat primarily around your waist, or being "apple-shaped", puts you at much greater risk of developing obesity-related health problems. The most practical way to determine whether you have too much abdominal fat is to measure your waist circumference.

A waist circumference above 39 inches (100cm), regardless of gender, is a strong risk factor for insulin resistance. Insulin resistance is a key player in metabolic syndrome and the precursor to type 2 diabetes.

Additionally, abdominal fat contains higher amounts of visceral fat. Visceral fat is made by your liver, turned into cholesterol, and released it into the bloodstream where it forms plaque on the artery walls. That's why you are more likely to have high cholesterol, high blood pressure, and cardiovascular disease when you have excess abdominal fat.

Who Benefits From Measuring Waist Circumference?

Waist circumference may be a better indicator of obesity-related diseases than BMI, especially among particular populations. The elderly, with less muscle mass, tend to have underestimated BMI values. Certain ethnic groups are genetically predisposed to storing more fat in the abdomen, even at healthy weights; these include non-Hispanic blacks, Mexican Americans, non-Hispanic whites, and people of Asian descent.

Having a history of alcoholism, which can cause central obesity syndrome, is a good indicator that waist circumference should be measured. Finally, if you are physically active and have a lot of muscle mass, but your BMI is above 25, you should certainly measure your waist.

How to Measure

Measure your waist circumference by locating your hip bone and snugly (but without compressing the skin) placing a tape measure around your bare abdomen. Make sure you are not holding your breath and that the tape measure is not at an angle around your waist.

If you are a woman with a waist circumference of at least 35 inches (88 cm) or a man with a waist circumference of at least 40 inches (102 cm), you are at greater risk, regardless of your BMI. It is not necessary to take this measurement if your BMI is 35 or above.

How You Can Reduce Your Waist Size

You cannot reduce your waistline through sit-ups or other spot-reducing exercises. You must reduce your intake of fat, saturated fat and total calories to promote weight loss. One study found that eating too much total fat and saturated fat was the biggest contributor to waist circumference.

Exercise also plays a key role in losing body fat. Be patient, though, since you tend to lose body fat last in the areas of your body where you store it first!


  • Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report. 1998; NIH Publication No. 98 - 4083
    http://www.nhlbi.nih.gov/guidelines/obesity/ob_g dlns.htm.
  • Wahrenberg H, Hertel K, et al. Use of waist circumference to predict insulin resistance: retrospective study. BMJ. 2005; 11: 330:1363-1364.
  • Comparison of determinants of frame size in older adults. Mitchell MC. J Am Diet Assoc. January 1993; 93:1, 53-57
  • Shankuan Z, Steven B, et al. Race-ethnicity-specific waist circumference cutoffs for identifying cardiovascular disease risk factors. Am J Clin Nutr. 2005: 81:409-415.
  • Aronne, LJ. Classification of Obesity and Assessment of Obesity-Related Health Risks. Obesity Res. 2002;10:105S-115.
  • Colby SE, Johnson L. Total and Saturated Fat Intake are Associated with Increased Waist Circumference. J Am Diet Assoc.2006;106 (Supp):A44.

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