The clustering of cardiovascular risk factors is linked to central obesity. Hypertension, diabetes, dyslipidemia, and metabolic syndrome are all recognized to be more common in people with central obesity. Waist circumference (WC) appears better to indicate central obesity than BMI and waist-to-hip ratio. The Waist circumference assessment is simple and has a stronger relationship with intra-abdominal fat level and cardiovascular risk factors. The recommended locations for WC measurements, on the other hand, differ. The World Health Organization (WHO) and the International Diabetes Federation (IDF) recommend measuring WC midway between the lowest ribs and the iliac crest in the horizontal plane.

The waist circumference and the waist-to-hip ratio, often known as the waist-to-hip ratio, are the two most frequent measures to evaluate abdominal obesity. Several organizations have established cut-points for abdominal obesity based on one or both of these measurements, with men and women having different cut-points (see table).

People with a large waist may be at a higher risk of health problems than those with a trim waist, even if they are not overweight.

What is it about abdominal fat that makes it such a reliable predictor of disease? The visceral fat surrounding the liver and other abdominal organs is extremely metabolically active. It produces fatty acids, inflammatory agents, and hormones, all of which contribute to elevated LDL cholesterol, triglycerides, blood sugar, and blood pressure.

How do I measure my waist circumference?

It’s essential to correctly measure your waist circumference to determine your risk level.

  1. Place the tape measure straight on your skin or over only one layer of light clothing.
  2. Using a non-stretchable tape measure, measure the distance around the narrowest part of your waist between the lowest rib and the iliac crest and above the umbilicus.
  3. Exhale normally and take a measurement.
  4. Make sure the tape is taut on the skin without squeezing it.

How do I measure my hip circumference?

Hip circumference is measured around the broadest part of the hips, where the buttocks protrude the most.

Which Is Best: Waist or Waist-to-Hip?

Scientists have long argued whether abdominal fat is the strongest predictor of health risk: Waist size alone or waist-to-hip ratio. The results of the research thus far have been mixed. When the evidence from several research is combined, it appears that both methods are equally effective at forecasting health risks.

In practice, measuring and interpreting waist circumference is more accessible than measuring both waist and hip circumference. As a result, waist circumference is the best option in many situations.

Abdominal Obesity Measurement Guidelines

OrganizationMeasurement usedDefinition of abdominal obesity
American Heart Association, National Heart, Lung, and Blood Institute Waist circumferenceWomen: > 88 cm (35 inches), Men: > 102 cm (40 inches)
International Diabetes FederationWaist circumferenceWomen: > 80 cm (31.5 inches), Men: > 90 cm (35.5 inches)Different cut-points for different ethnic groups
World Health Organization Waist-to-hip ratioWomen: > 0.85, Men: > 0.9


Selected circumference measurements may be helpful in estimating chronic disease risk and analyzing body composition changes. Using a non-stretchable tape measure, measure the distance around the narrowest part of the waist between the lowest rib and iliac crest and above the umbilicus. Hip circumference is measured around the broadest part of the hips, where the buttocks protrude the most. Circumferential or girth measurements may be used since fat distribution is a risk indication. Excess body fat around the belly that is out of proportion to total body fat is a risk factor for obesity-related chronic diseases and metabolic syndrome. A WC of more than 40 inches (102 cm) for men and more than 35 inches (88 cm) for women is a risk factor for metabolic disease on its own. These measurements may not be as valid for persons under 60 inches tall or with a BMI of 35 or above. Except when BMI is greater than or equal to 35, WC is thought to be a more accurate predictor of metabolic risk than BMI.


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