Waist Circumference and Your Health

Your Waist Is a Measurement of Your Health Risks

Woman measuring her waist
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Your waist circumference is an important number to know, especially if you are living with a chronic issue such as heart disease or have a risk factor for diabetes, such as a family history. In fact, research shows waist circumference may be as important as body mass index (BMI)—the ratio of weight to height that can indicate obesity—for predicting disease risk and overall health status.

Even someone who is not overweight and whose waist is wide in relation to their hips is at an increased risk of developing type 2 diabetes.

Although BMI is a helpful indicator in some cases, it does not indicate how fat is distributed in the body. In contrast, a large waist circumference indicates an accumulation of fat in the intra-abdominal region where it can impact internal organs and is more metabolically active than fat in other areas of the body.

How to Measure Your Waist Circumference

Getting an accurate waist measurement is fairly simple:

  1. Stand up straight and relax. Exhale normally.
  2. Locate your hip bones and wrap a tape measure around your body just above them. A good spot to aim for is halfway between your hip bone and the lowest rib. This spot should generally be just above your bellybutton but can vary in some individuals.
  3. Make sure the tape measure is flat against your body and parallel to the floor. It should be snug against your skin but not tight.

Waist Measurement Recommendations

The American Heart Association recommends the following parameters for waist circumference in adults:

  • Men: 40 inches or less
  • Women: 35 inches or less

The current recommendation from the American Heart Association is for waist circumference to be evaluated in people with a BMI of 25 or higher. However, at least one study has revealed that the risk for developing diabetes was stronger for people who had a lower BMI but had a high waist circumference.

A BMI below 18.5 is considered underweight, between 18.5 to 24.9 is optimal, between 25 to 29.9 is overweight and over 30 is technically considered obese. Body mass index can be calculated by comparing height to weight.

To find your BMI, take your weight in pounds and divide by your height in inches. This should then be multiplied by 703 to convert from lbs/inches2 to kg/m2.

When used alone, a BMI measurement is not especially accurate at predicting health and heart disease risk. But when used in conjunction with waist circumference, it provides a clearer picture.

Risks of Having a Large Waist Circumference

There are several serious risks associated with having a waist circumference larger than 35 inches in women or 40 inches in men, including:

Waist Circumference and Metabolic Syndrome

Metabolic syndrome is a cluster of medical conditions that occur together and increase one's risk for diabetes, heart disease, and stroke. Abdominal or central obesity (having a large waist circumference) along with insulin resistance are considered the two most important risk factors.

Causes of a High Waist Circumference

A larger waist circumference is often caused by intra-abdominal visceral fat. Visceral fat is fat that develops between and around internal organs. This type of fat differs from "regular" fat that sits just beneath the skin and can be pinched. This type of fat is deep within the abdomen and is considered to have very high inflammatory activity.

Fat cells were once thought to be solely for energy storage. However, it is now known that they also secrete hormones. They play a part in response to infection, inflammation, and injury, among other things. They also secrete both inflammatory and anti-inflammatory substances. Inflammation may be a major factor in the onset of diabetes. Fat cells secrete adiponectin, a protein hormone which improves insulin sensitivity and lowers the risk of atherosclerosis and diabetes. However, less adiponectin is produced as fat cells increase.

If you are stressed physically, mentally, or emotionally, you may have high levels of the stress hormone cortisol. Chronically elevated levels cause your body to deposit more visceral fat in the abdomen.

How to Reduce Your Waist Circumference

There are several effective ways to reduce your waist circumference in a healthy manner.

  • Lifestyle changes, including eating a healthy diet and getting regular exercise
  • Quitting smoking and sustaining it long-term
  • If you have type 2 diabetes, metformin and thiazolidinedione medications may provide benefits in helping to reduce waist circumference

Work with your primary care provider to determine the best method for you to reduce your waist circumference if you're over the recommended guidelines.

May 28, 2020: The FDA has requested that manufacturers of certain formulations of metformin voluntarily withdraw the product from the market after the agency identified unacceptable levels of N-Nitrosodimethylamine (NDMA). Patients should continue taking their metformin as prescribed until their health professional is able to prescribe an alternative treatment, if applicable. Stopping metformin without a replacement can pose serious health risks to patients with type 2 diabetes.

A Word From Verywell

There are many measures of overall health and wellness, and waist circumference happens to be just one. It is not the be-all, end-all metric, but it can be a helpful clue in determining your long-term health. If you are concerned about your waist measurement, consult with your doctor about safe ways to lose weight and reduce your risk of chronic disease.

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  1. Hajian-tilaki K, Heidari B. Is waist circumference a better predictor of diabetes than body mass index or waist-to-height ratio in Iranian adults?. Int J Prev Med. 2015;6:5. doi:10.4103/2008-7802.151434

  2. American Heart Association. Body mass index (BMI) in adults. Updated August 1, 2014.

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