<p>“Six reasons why the waist-to-height ratio is a rapid and effective global indicator for health risks of obesity and how its use could simplify the international public health message on obesity” by MARGARET ASHWELL & SHIUN DONG HSIEH</p>
<p>Margaret Ashwell has been promoting “Keep your waist circumference to less than half your height” as a better alternative to using body mass index or weight-based methods to measure obesity. While her arguments make perfect sense, the use of waist / height < 0.5 as a target for obese people to get to has not caught on or displaced weight based goals.</p>
<p>Makes sense to me–and confirms what my doc has said, that since all my excess weight is below my waist, I’m not in the kind of risk that my BMI would suggest.</p>
<p>Which means that it is not a better way to measure “obesity.” Perhaps a better way to measure health risk at any height and weight.</p>
<p>As a natural apple, I have to be significantly slimmer than a pear or hourglass to get my waist measurement that low. They could easily outweigh me by significant poundage at the same height. Like 15-20 lbs. Or more.</p>
<p>Just another way in which life in unfair. ;)</p>
<p>“While her arguments make perfect sense, the use of waist / height < 0.5 as a target for obese people to get to has not caught on or displaced weight based goals.”</p>
<p>Because obese folks can not do anything about denominator while the numerator can be adjusted downwards with diet and exercise. Besides, a 5 pound weight loss just sounds so much more “measurable” and significant than a 0.02 point loss in the waist/height ratio. :)</p>
<p>Ditto. Soooooo frustrating. If you only saw my legs in short shorts, you’d assume I have a rocking body because they are slender and muscular from resistance training and genetics. If my trunk matched my legs, I WOULD have a rocking body, lol, but sadly, I have to struggle, struggle and struggle just to get it to even a remotely satisfactory measurement. My mom was the same, so part of my brain says I’m not going to be able to win this one. My central adiposity didn’t show up until perimenopause; so far the only thing that helps is to do a restricted carbohydrate diet.</p>
<p>I find arguments about the best measures kind of silly because (1) they should all basically approximate each other in all but a few cases and (2) the people who need help with weight either know it or are lying to themselves about it. </p>
<p>I use two proxies myself: how do I look and my waist size. Like all of us, I have to allow for differences in sizing, but generally if 32 waist pants are loose, I’m ok. If 31 waist pants are loose, I’m closer to where I want to be but have trouble reaching. If 30 waist is loose, then I’m probably not going to keep that weight.</p>
<p>I found it interesting because being a pear (or more like a bowling pin!), BMI charts raise red flags for me, but I’m on the edge of fine for waist-to-height (about a half inch off.) and that makes sense that it’s not that much of a problem, given that my heart-rate, blood sugar, cholesterol and blood pressure are all in the normal range.</p>
<p>I must say, though, from a fashion perspective, I envy you apples. My legs in shorts or dresses are like tree trunks. I may have a decent sized waist, but then skirts flare out like an elephant in a tutu, so I almost never wear dresses, and sort of dread shorts weather.</p>
<p>Real life examples include people who have a lot of both muscle and fat. Realistic fat loss goals based on weight may be hard to set, since the normal ranges do not assume a lot of muscle weight. However, fat loss goals based on waist/height are more realistic. Using waist/height can also alert people who are muscular that they also have more than a healthy amount of fat, since many dismiss weight or BMI charts as inapplicable to them (which is true due to having a lot of muscle).</p>
<p>I hardly ever wear dresses anymore because of the whole big waist thing (if you size the dress to match the waist it looks huge), which as a lifelong slender person is really disheartening. But yeah, I can do shorts.</p>
<p>You could also have too large of a waist to height ratio and be of perfectly normal weight. This does not, however, mean you are not going to be at risk for adverse events which are associated with this wait/height ratio.</p>
<p>I’m at a perfectly healthy BMI and normal weight. Yet it’s my mission to lose body fat from my trunk.</p>
<p>I realize weight charts penalize me because I have a 31 inch waist and yet am “overweight” with a BMI of around 26. I’m not hugely muscular, just in good shape but I have big shoulders and dense bones from exercise and muscle instead of fat. But anyone in my condition - or pretty much any condition - knows how the metric fits and doesn’t fit.</p>
<p>My waist to height ratio is fine but I am still about 15lbs overweight… interestingly my BMI is just a teeny bit over, and I have put on so much muscle that I now fit into some pairs of pants that I used to only be able to fit into when I was 15lbs lighter. I make no sense.</p>
<p>Being overweight with only muscle while having a low body fat percentage (as indicated by a good waist/height ratio) is healthy. This is actually the “athletic” or “mesomorph” body type that many people (particularly men) look to as their goal.</p>
<p>Muscle is more dense than fat, so it is not surprising to be smaller but heavier if you gained muscle and lost fat. Note, however, that floating in water will be more difficult for someone with a lower body fat percentage (the underwater weighing method of estimating body fat percentage is based on this).</p>
<p>This may indicate a high body fat percentage, a condition sometimes called “normal weight obesity”, where one has increased risk of obesity-associated health problems.</p>
<p>^^^^Yes, that is me! Trying so hard to fight it, and just so frustrating! Lifelong slender person here, just like many here, “Oh, it’s so easy. Just work out and watch what you eat, what is wrong with you?”</p>
<p>Yeah, then I had neck surgery, and had hot flashes from day one, and put on weight like crazy. My little holier than thou attitude had a real meet reality experience, let me tell you.</p>
<p>Interesting. According to both BMI and this measure, I am just slightly into overweight territory (26 BMI, 35 inch waist and 68 inches tall). </p>
<p>I used to work at a Men’s wearhouse, I once saw someone with a 68 inch waist (highest I ever measured - guy couldn’t have been taller than 5’10"). Gotta wonder, what does a ratio of near 1 mean?</p>
Guess I better spend more time with the hula-hoop I just bought. But I can’t get the Chipmunks song with Alvin singing:</p>