Is Your Waist-to-Hip Ratio More Important Than Your BMI?
When you visit your doctor, they check your blood pressure, heart rate, and BMI. For years, doctors have used BMI (Body Mass Index) to decide if someone is at risk for serious health problems like heart disease, diabetes, and high cholesterol.
For further information about the origin of BMI and why it is used to predict the risk of disease you can read my previous blog [Click Here to read previous blog]. But new research shows there might be a better way to measure your health risk.
What BMI Misses
BMI only looks at your weight and height. It treats all body fat the same way. But not all fat is equal. The location of fat on your body matters more than you might think. Your waist-to-hip ratio tells a different story. This simple measurement can predict your risk of heart disease and diabetes better than BMI alone.
Why Location Matters: Two Types of Fat
Your body stores fat in two main places, and they affect your health very differently.
Visceral fat sits deep inside your belly, around your organs. This is the dangerous type. It releases chemicals that cause inflammation throughout your body. Think of it as an active troublemaker that won't stay quiet.
Subcutaneous fat sits just under your skin, like in your hips and thighs. This fat is much less harmful to your health. It can cause some problems like joint pain or sleep issues, but it doesn't attack your organs like belly fat does.
The Power of Measurement
Here's what makes waist-to-hip ratio so useful: your waist size shows how much dangerous belly fat you have. Your hip measurement shows how much of the safer subcutaneous fat you carry.
When you divide your waist measurement by your hip measurement, you get a single number that tells you about your health risk.
Healthy ratios:
Women: less than 0.85
Men: less than 0.90
Research shows the numbers don't lie. When waist size increases by just 4 inches, the risk of heart disease jumps by 45%. The risk of dying from any cause goes up by 8%.
How to Measure Correctly
Getting accurate measurements takes some care, but it's worth the effort. [Click here for measurement instructions]
When to measure: Take your measurements when you start your weight loss journey and each time you lose 10 pounds. This simple approach means you'll automatically re-measure after losing about 5% of your body weight without having to calculate percentages.
How to measure: Use a soft measuring tape and don't pull it too tight. Stand straight and breathe normally when taking measurements.
What You Can Do
Talk to your doctor about lifestyle changes. Even losing 5% of your body weight can lower your heart disease risk significantly.
Consider your options based on your measurements. The higher your waist-to-hip ratio, the more aggressive your approach might need to be:
Lifestyle changes alone can help with modest weight loss. For more significant results, medications can help people lose 10% to 20% of their body weight. Bariatric surgery can lead to 25% to 35% weight loss for those who need it most.
Pay special attention after menopause. Many women notice their belly growing after menopause due to hormone changes. This usually means visceral fat is increasing, making waist-to-hip ratio even more important to track.
The Bottom Line
Your waist-to-hip ratio gives you and your doctor better information about your health than BMI alone. It's a simple measurement that can help guide important decisions about your health care.
Reducing visceral fat doesn't just improve your numbers on paper. It can add years to your life and life to your years. A medical weight loss specialist can help you create a plan that works for your specific situation and health goals.
The tape measure around your waist might be telling you more about your future health than the scale ever could.
Stay Healthy, Stay Strong
Dr. Leon Katz
Diplomat American Board of Obesity Medicine (ABOM)
www.drkatzweightloss.com
This information is for educational purposes. Please discuss this with your doctor or nurse practitioner prior to pursuing these medications.
Sources:
Waist to Hip ratio in cardiovascular disease risk: a review of the literature.
Edwin Destra, MD et al. MALAHAYATI HEALTH STUDENT JOURNAL, 3 NOMOR 6 TAHUN 2023 HAL 1770-1781 https://bit.ly/3FGuzsB
Estimated visceral adiposity is associated with risk of cardiometabolic conditions in a population based study. Maria Ruiz-Castell, MD et al. Scientific Reports | (2021) 11:9121 https://bit.ly/45HZnUv
Gender Differences of Visceral Fat Area to Hip Circumference Ratio for Insulin Resistance. Huiying Cao MD et al. Diabetes, Metabolic Syndrome and Obesity Volume 17, 2024 Pages 3935-3942. https://bit.ly/4n0VQGH
