A team of researchers is making a case for healthcare providers to consider monitoring waist circumference as a vital sign in addition to BMI.
It has long been argued that BMI does not always accurately indicate obesity. This is especially true for athletes whose muscle mass makes them appear heavy for their height leading to a BMI that places them in the obesity category (BMI > 30). By adding waist circumference to the health record it can more accurately indicate obesity.
Waist circumference is measured by using a tape measure to measure the girth around a person’s abdomen (the process is explained here). This measurement is a representation of how much visceral fat a person has. Visceral fat is the fat stored in the abdomen and as padding around several vital organs. This type of fat poses a significant health risk. High waist circumference (and thus large amounts of visceral fat) is a strong predictor of death risk.
Researchers also point out that reductions in waist circumference that accompany lifestyle-induced losses (such as diet and exercise) are associated with improvements in cardiometabolic risk factors. As people who have made lifestyle changes can often attest, we can often see reductions in our body size and measurements that are not reflected in a scale. Exercise leads to building muscle in addition to loss of fat. This may negate an actual reduction in weight while still producing obvious reductions in body size or clothing size. While BMI may not reflect the improvements in body composition, waist circumference may be more positively affected. This is why experts argue both BMI and waist circumference should be measured.
While experts have suggested a change to the current guidelines, they admit that more studies are needed to ascertain the best evidenced-based values of waist circumference for each sex, age, and ethnicity wtihin each BMI category. In the meantime, monitoring our own waist circumference along with our body weight and BMI can be a good way to keep track of weight loss progress. It may be especially helpful during the times of a weight loss plateau. Even if your scale may not show your progress, your waist circumference may decrease, which can help keep you motivated to continue your diet and exercise regime.
If your BMI and waist circumference indicate you have obesity (find your BMI here), and diet and exercise have not led to sustained weight loss, you may be a candidate for bariatric surgery. Dr. Shillingford, MD, PA performs gastric sleeve, gastric bypass, and lap band surgery for qualified candidates with or without insurance. To attend one of Dr. Shillingford’s weekly Informational Sessions to learn more about gastric sleeve, gastric bypass, and lap band surgeries, call his Boca Raton office at (561) 483-8840.