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BMI vs. waist circumference: Which is a better measure?

Wellness
Feet on a bathroom scale

It’s no secret that weight influences our risk for diabetes, stroke, heart disease and other health conditions. That’s why a weight assessment is an important part of determining your overall health.
Physicians and other care providers typically use two tools – body mass index and waist circumference – to help determine if someone is within established guidelines for a healthy weight.
BMI is calculated by comparing your weight to your height, says Dr. Kimberley Drayton, a family medicine physician who practices at Tidelands Healthy Family Medicine at Pawleys Island.
“It’s useful for measuring whether patients are overweight or obese,” she says. “It estimates body fat and helps us gauge your risks for certain diseases.”

The ranges

A BMI of 18.5-24.9 is considered normal for adults. If your BMI is 25-29.9, you are considered overweight. BMIs from 30-34.9 are considered obese, and anything above 35 is very obese. You can calculate your own BMI using an online calculator.
BMI isn’t accurate for everyone. People who have a lot of muscle mass may have inaccurately high BMI scores while older adults who have lost a lot of muscle mass may have BMIs that aren’t representative of the amount of fat in their bodies.

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That’s why waist circumference is often a good estimate of body fat for athletes and other body types, Dr. Drayton says.
Waist circumference is a simple measurement of the circumference of the gut. Abdominal fat is generally considered to be a good predictor of health risk since abdominal obesity often correlates with increased risk of cardiovascular disease, metabolic syndrome, high blood pressure and type 2 diabetes.
Waist circumferences of more than 40 inches in men and 35 inches in women are associated with elevated cardiovascular risk.

Only part of the equation

While both BMI and waist circumference are helping at gauging overall health, it’s important to remember they are only part of the equation, Dr. Drayton says.
Care providers will also look at a variety of other information to help you improve your health such as cholesterol and triglyceride levels, blood sugar levels, blood pressure and lifestyle choices such as how much you exercise and whether you smoke tobacco.
“Ultimately, we all have a lot of control over our health outcomes,” Dr. Drayton says. “BMI and waist circumference are both good tools that can help us develop an overall picture of your health and identify ways to improve it.”

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