Recently I wrote about how I was going to focus on things other than my weight during my training plan because I didn’t want to restrict my food and underfuel. I’d like to avoid going too far in the overfueling direction, so I’m going watch things like how my clothes fit, body fat and measurements. A commenter pointed out that waist circumference is really the only thing you need to measure and I thought it would be good to talk about why that might be true.
Waist circumference has been shown to provide information about risks of obesity-related disease above and beyond that provided by BMI alone. Specifically, it is associated with an increased risk of type 2 diabetes, cholesterol and triglyceride abnormalities, high blood pressure, heart disease and overall mortality. This is particularly true in patients in the overweight to obese range, with BMI less than 35. It helps us answer the question of “overweight but healthy” people like me, with BMI in the 26-27 range but no apparent health problems and a healthy lifestyle.
Why might waist circumference be a better measure of risk? It has to do with where you have your body fat. While overall obesity is associated with an increased risk things of like heart disease, fat that we carry around our abdomen is particularly high risk. Other advantages of waist circumference are practical. In some patients, we can’t measure height, which is a key part of the BMI formula. Even when we can measure height, we often don’t. Most clinics I’ve been to just ask how tall I am and my self report could skew my BMI numbers.
So where do you measure?
This graphic is from the NIH (here), showing where you should actually put the measuring tape. Stand up straight and ideally, measure first thing in the morning before you eat or drink so you’re not measuring breakfast. Don’t suck in, no matter how tempted you may be.
I have yet to have my waist circumference measured at a doctor’s office, but that day may be coming. In the meantime, it’s an easy and an important thing to measure at home with my handy dandy measuring tape. If you want to read more about the science behind waist circumference, check out this extensive review from the WHO.
Do you measure your waist circumference? Have you ever had it checked at a doctor’s office?