Body Mass Index Using Waist Circumference for Adults

Even though BMI and waist circumference are interrelated, the latter is more accurate in predicting disease risk especially for people categorized as overweight or normal on BMI scales.  Waist circumference is incorporated when evaluating the body mass index of adults since it provides a more accurate estimation of visceral fat. This is the layer of fat that coats internal organs and predisposes people to health risks (Centers for Disease Control and Prevention, 2018).  When people carry excess fat around the middle part of their body, they experience higher risk of terminal illnesses such as diabetes and heart disease, as compared to the presence of fat on their thighs and hips (Flint et al., 2010). Waist circumference in adults is specifically accurate in predicting risks of Type 2 diabetes, cardiovascular disease, high blood pressure, and metabolic syndrome. 

How Tool is Used in Healthcare

To assess the level of risk to patients, it is imperative that the waist circumference is measured accurately. The physician should place the tape either directly over the patient’s skin or light clothes (Centers for Disease Control and Prevention, 2018). The tape should be placed halfway between the top of the hipbone and the lowest rib, and this normally corresponds to the belly button. The tape should not squeeze the skin, and measurement should be done once the patient breathes out. Certain thresholds indicate elevated risk of diseases and for women, they face risk if the waist is 80cm or more, and the level of risk increases significantly if measurement is 88cm or more. For men, they experience risk if the waist is 94cm or more, and the risk is elevated considerably if they measure 102cm or more (Centers for Disease Control and Prevention, 2018). 

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Validity and Reliability

Waist circumference is a reliable screening tool. Research by Barrios et al. (2016) on 41 mothers revealed that waist measurement was highly reliable (≥0.90), and there were minimal differences between measurements conducted by technicians versus self-measurements (mean difference of −0.13 to 0.06 inches). However, waist measurement is more reliable for people who are overweight or normal on the BMI scale.  This is because the BMI scale does not provide additional prediction of disease risk for this category of people, unlike waist measurement. For people with a BMI of 35 or greater, both the BMI and waist circumference will indicate the risk of diseases such as cardiovascular diseases and Type 2diabetes (Flint et al., 2010).  This tool is also unreliable in certain conditions that affect enlargement of the abdomen. For instance, it is not accurate when used for pregnant women, or for patients suffering from conditions which make the abdomen enlarge. Moreover, waist circumference is merely a screening tool but cannot diagnose the health of individuals; further health assessments should be conducted by trained professionals (Flint et al., 2010). 


The measurement of waist circumference is a reliable indicator of increased risk of certain diseases such as diabetes Type 2 and cardiovascular illnesses. This tool is also accurate for people who are either normal or overweight on the BMI scale. However, it is only a screening tool and cannot be used to diagnose illness. Moreover, it is unreliable when used on patients with conditions that make their stomachs enlarge. Healthcare practitioners should combine this tool with other assessment methods to accurately diagnose and treat patients. 


Barrios, P., Martin-Biggers, J., Quick, V., & Byrd-Bredbenner, C. (2016). “Reliability and 

criterion validity of self-measured waist, hip, and neck circumferences”. BMC medical Research Methodology, 16, 49. doi:10.1186/s12874-016-0150-2

Centers for Disease Control and Prevention. (2018). Assessing Your weight. Retrieved from

Flint, A. J., Rexrode, K. M., Hu, F. B., Glynn, R. J., Caspard, H., Manson, J. E., Willett, W. 

C. & Rimm, E. B. (2010). “Body mass index, waist circumference, and risk of coronary heart disease: a prospective study among men and women”. Obesity research & clinical practice, 4(3), e171-e181.

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