U.S. Department of Health and Human Services
Indian Health Service: The Federal Health Program for American Indians and Alaska Natives
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Thursday, October 23, 2014

Division of Diabetes Treatment and Prevention - Leading the effort to treat and prevent diabetes in American Indians and Alaska Natives


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Waist Circumference

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NOTE: Access to this information is not restricted; however, the information found here is intended for use by medical providers. Some videos contain graphic images. Patients should talk with their medical providers about any specific concerns.

Why measure a waist circumference (WC)?

  • WC provides an independent prediction of risk over and above that of BMI.
  • It is a practical tool to evaluate abdominal adiposity before and during weight loss treatment.
  • Increased abdominal adiposity is associated with increased risk for type 2 diabetes, dyslipidemia, hypertension and CVD.
  • WC measurement is particularly useful in individuals who are categorized as normal or overweight in terms of BMI.

Measuring WC

  • A spring-loaded cloth tape measure (like a Gulick) ensures accurate and repeatable measurements.
  • The spring-loaded tape measure reduces inter- and intra-individual measurement error and improves test/retest reliability.
  • Locate the iliac crest or top of the hip bone.
  • If the iliac crest cannot be located, measure above the umbilicus but below the xiphoid process of the ribcage.
  • Place the tape measure evenly around the bare abdomen at the level of the iliac crest.
  • Ensure that the tape does not compress the skin and is parallel to the floor.
  • Instruct the individual to breathe out normally and make sure that they do not ‘suck in’ their stomach.
  • Read the tape measure and carefully record the measurement. Allow the skin to relax and repeat the process.
  • If each measurement is within a 1/4 inch, record the average of the two measurements.
  • At each visit carefully measure the same anatomical landmarks and tape orientation so any change reflects a true change and not measurement error.

Interpreting WC

  • Increased health risks are found at:
    • >40 inches (>102 cm) for men.
    • >35 inches (>88 cm) for women.
Overview How To Other Resources EHR Documentation

Division of Diabetes Treatment and Prevention | Phone: (505) 248-4182 | Fax: (505) 248-4188 | diabetesprogram@ihs.gov