But physicians also consider another measurement in diagnosing obesity. Simply waist size. Something most of us don’t think about until we want to buy new clothes, or notice that the old ones don’t fit. But an elevated waist circumference can be a problem for more reasons than making it hard to fasten your seat belt on an airplane. It correlates with a greater risk of the same conditions that elevated BMI is, especially type 2 diabetes mellitus and cardiovascular disease.
So how high is too high? In the United States, the following values are used most often.
for women, a waist greater than 35 inches (88 centimeters)
for men, a waist greater than 40 inches (102 centimeters)
Another related value is the waist-to-hip ratio; disease risk is increased
for women, if the ratio is greater than 0.85 and for men if greater than 0.9
Or another easy way to remember this is – Your waist size should measure less than your hips. ( that is, a ratio less than 1)
Learn more in this discussion on waist size from Harvard.
Healthcare professionals, educators, employers, and elected officials agree that overweight and obesity (I will explain the difference later) are significant health problems in the United States, and now worldwide. It is one of the most written and talked about issues in the media; every health and fitness publication gives extensive coverage to it, as well as lifestyle, women’s, and even news magazines.
We need to understand what it is and what it is not. When I was in an office practice, patients often wanted to discuss their weight, and how to weight less. Some people felt overweight because they weighed more than they did as a young adult, or more than they weighed five years ago. Sometimes it was because they no longer fit into their clothes, or because it was harder to be physically active. Some of these people met the medical definition of overweight/obesity, but often they did not.
Conversely, some people who were significantly overweight ,even obese, never mentioned their weight as an issue of concern. Sometimes they seemed surprised when I told them that they weighed too much. I supposed they had been heavy for so long that they considered it normal, or were just resigned to it.
The simplest definition of overweight/obesity is excess weight specifically due to excess body fat ( adipose tissue.)
In Stedman’s Medical Dictionary it is “excess subcutaneous fat in proportion to lean body mass.”
To determine excess weight, physicians use the body mass index, BMI, which is the weight in kilograms divided by height in meters squared. Since most of us in the United States are not fluent in the metric system, or capable of math computing in our head, there are charts, apps and on-line calculators which do the work for us. Electronic health records calculate it automatically also.
So depending on what your BMI is, you may be underweight, normal weight, overweight or obese as illustrated by this chart.