Rutgers study finds waist circumference rivals complex obesity measures

August 31, 2026 at 05:00 AM2 min

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A Rutgers Health study published in JAMA Network Open found that waist circumference alone or with BMI identifies obesity-related health risks about as accurately as a more complex multi-measurement framework. The analysis of 1,900 U.S. adults aged 20-59 showed simpler methods provided a better balance between correct identification and avoiding false positives. The findings suggest routine waist measurement could enable earlier detection of diabetes, heart disease, stroke and some cancers.

Key Facts

The study analyzed data from 1,900 U.S. adults aged 20 to 59 who participated in the National Health and Nutrition Examination Survey.
Waist circumference alone performed nearly as well as a proposed framework combining BMI, waist circumference, waist-to-height ratio, and waist-to-hip ratio.
Using either BMI or waist circumference provided a better balance between correctly identifying people with obesity and avoiding false-positive diagnoses.
Hip circumference, required for one measurement in the proposed framework, is rarely recorded during routine clinical visits.
Lead author Aayush Visaria is a faculty member of the Rutgers Health-RWJBarnabas Health Center for Climate, Health, and Healthcare and an instructor at Rutgers Robert Wood Johnson Medical School.

Study Design

Rutgers Health researchers analyzed information from 1,900 U.S. adults between the ages of 20 and 59 who took part in the National Health and Nutrition Examination Survey. The researchers compared several ways of identifying obesity with a highly accurate method for determining body fat. One of the methods evaluated was a recently proposed obesity framework developed by a multidisciplinary group of independent experts. That approach combines BMI, waist circumference, waist-to-height ratio and waist-to-hip ratio.

Findings

Although the newer framework identified a larger number of people with excess body fat, the Rutgers team found that much simpler methods produced similar levels of accuracy. Using either BMI or waist circumference provided a better balance between correctly identifying people with obesity and avoiding false-positive diagnoses. Even when used on its own, waist circumference performed nearly as well. Hip circumference, which is needed for one of the measurements in the proposed framework, is rarely recorded during routine clinical visits. Waist circumference is much easier to measure and is increasingly included in clinical guidelines, according to the researchers.

Clinical Implications

Lead author Aayush Visaria said that a waist measurement provides much of the information needed and is feasible for clinicians and patients alike. Visaria noted that paying attention to the need to loosen a belt or get bigger pants can be an early sign of unhealthy amounts of body fat. Measuring waist along with weight can help identify health risks earlier and provide an opportunity to reduce the risk of diabetes, heart disease, stroke and some cancers.