A study found that the measurement performed nearly as well as an obesity definition based on multiple body measurements.
A tape measure around the waist may provide surprisingly useful information about obesity-related health risks. Rutgers Health researchers found that waist circumference can identify potentially unhealthy levels of body fat with accuracy comparable to more complicated approaches that require several body measurements.
The study, published in JAMA Network Open, found that waist circumference alone, or waist circumference combined with body mass index (BMI), performed as well as a recently proposed definition of obesity that incorporates multiple measurements.
The results suggest that measuring the waist could give clinicians and patients a practical way to identify excess body fat and related health risks without relying on a more complicated screening process.
“Pay attention to the need to loosen your belt or get bigger pants,” said Aayush Visaria, a faculty member of the Rutgers Health-RWJBarnabas Health Center for Climate, Health, and Healthcare and lead author of the study. “Although clothing size isn’t the same as a proper waist circumference measurement, it can be an early sign of unhealthy amounts of body fat. Measuring your waist, along with your weight, can help identify health risks earlier and provide an opportunity to reduce your risk of diabetes, heart disease, stroke, and some cancers.”
Simpler measures match complex screening
To compare different ways of identifying obesity, the Rutgers Health researchers analyzed data from 1,900 U.S. adults ages 20 to 59 who took part in the National Health and Nutrition Examination Survey. They evaluated several obesity definitions against a highly accurate method for measuring body fat.
One of those approaches was a recently proposed framework developed by a multidisciplinary group of independent experts. It combines BMI, waist circumference, waist-to-height ratio, and waist-to-hip ratio. Although that framework identified more people with excess body fat, the researchers found that simpler methods produced similar accuracy.
Using either BMI or waist circumference provided a better balance between correctly detecting people with obesity and limiting false positive diagnoses. Waist circumference by itself performed nearly as well.
That simplicity could matter in routine medical care. Hip circumference, which is required for one of the measurements in the newly proposed framework, is rarely recorded in clinical practice. Waist circumference, by comparison, is relatively easy to measure in primary care and is receiving greater recognition in clinical guidelines.
“Our findings show that you don’t necessarily need multiple complex measurements to identify obesity-related health risks,” said Visaria, who also is an instructor in the Department of Medicine at Rutgers Robert Wood Johnson Medical School. “A waist measurement provides much of the information needed and is feasible for clinicians and patients alike.”
BMI alone misses some obesity cases
BMI by itself was less complete. The researchers found that it failed to identify a substantial number of people who met body-fat criteria for obesity, adding to concerns that BMI does not fully account for differences in body composition or where fat is stored.
The findings could help shape future recommendations for obesity screening and support more routine use of waist circumference in health care.
Reference: “Lancet Definition vs Other Criteria for Obesity Diagnosis in Adults” by Aayush Visaria, Douglas Corsi, Dylon Patel, Keerthana Kesavarapu, Ethan A. Halm, Jeffrey Carson and Soko Setoguchi, 7 August 2026, JAMA Network Open.
DOI: 10.1001/jamanetworkopen.2026.27738
This study was supported by grant K12TR004788 from the National Institutes of Health (NIH) National Center for Advancing Translational Sciences and pilot grant P50MD017356 from the NIH National Institute on Minority Health and Health Disparities Rutgers-New York University Center for Asian Health, Promotion, and Excellence.
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