If you struggle with excess weight, most likely your health care visits include measurements of your weight, height, and blood pressure, as well as a calculation of your BMI (body mass index).
But what about your waist circumference?
As an obesity medicine physician specialist, I’ve been measuring waist circumference on my patients for over 25 years since the first Obesity Guidelines were published in 1998.
With 2 out of every 3 patients seen in health care practices having excess weight, I’m encouraging primary care professionals to consider using a tape measure for waist size measurement as frequently as they use a blood pressure cuff.
Whether you’re a patient or a healthcare professional, here are some key points to know:
1-Waist Size Measurement is a Better Marker for the Diagnosis of Obesity and to Estimate Health Risk
BMI measurements alone do not tell the whole story of how excess fat is affecting someone’s health.
This can lead to mis-diagnosis due to differences in body type.
For example, 2 people can have the same BMI.
One may carry excess fat in the hip area (lower risk for developing metabolic diseases) while another person may have excess belly fat which tends to be more harmful and raises risks for developing heart disease and diabetes.
Furthermore, a person can have a normal BMI, yet have excess fat around the abdomen.
Waist size and BMI together give clinicians and patients more information that can impact treatment decisions.
2-Waist Size Measurement Help Stratify Risk, Impact Treatment
Knowing waist circumference helps stratify those patients at the highest risk of developing further health problems from the disease of obesity.
Abdominal or visceral fat is the most harmful to one’s health.
This directly impacts treatment decisions.
3- Waist Circumference Measurements in Adults Vary by Age, Sex and Ethnicity
Waist circumference thresholds exist.
For example, the cut point to determine an elevated health risk due to an enlarged waist circumference is lower for women and Asians compared to men and Whites.
Information on how to measure waist circumference and which cut points to use can be found here.
Please note that obesity guidelines recommend measuring waist circumference for those with a BMI less than 35.
4-Waist Circumference Measurements Can Help Mark Patient Progress over Time
Waist circumference measurements can be followed every 3 to 6 months to help gauge progress over time.
This is in addition to monitoring someone’s weight changes and changes in other health parameters such as blood pressure or blood sugar readings.
Though the literature on this topic notes some variability in waist circumference measurements depending on landmarks used, it is still recommended for daily practice when caring for patients with excess weight.
When your clinician can better assess how excess weight is affecting each patient’s health, this can improve shared decision making and help personalize treatment.
I encourage all patients to take a more active role in your weight management care by bringing up this topic at your next health care visit.
RK
Robert Kushner, MD
