Beyond BMI: A Better Tool to Measure Your Health

Waist-to-height ratio is better — and simpler

Tape measure

If you’ve been to a doctor, looked at medical websites or watched a daytime talk show, you’ve probably heard the three magic letters BMI.

BMI, or body mass index, is the most basic tool doctors use to check your body composition and predict your risk of disease. There are plenty of online BMI calculators that will do the math for you, but it turns out there is a better tool at your disposal: waist-to-height ratio. Best of all, just like BMI, you can measure it yourself.

DIY disease predictor

All you need to measure BMI is your height and weight — plus a calculator or good head for math. All you need to measure your waist-to-height ratio is your waist size and height. A tape measure will do the trick.

“All you need to measure your waist-to-height ratio is your waist size and height. A tape measure will do the trick.”

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Karen Cooper, DO

Women’s Health Institute

But waist-to-height ratio isn’t just simpler; it’s also better. Researcher Margaret Ashwell made the case for this measurement last year after studying the health of 300,000 patients. She found that waist-to-height ratio is better than BMI at predicting diabetes, hypertension, heart attacks and strokes.

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BMI doesn’t take into account lean body mass versus body fat, so a very muscular person could end up classified as overweight and at-risk. Waist-to-height ratio does a better job of avoiding that problem by including the waist, where abdominal fat lives. Abdominal fat seems to be the worst kind when it comes to disease risk.

How to measure

To be healthy, your waist circumference should be less than half of your height. For example, if you are a 5-foot (60 inches) female, your waist circumference should be 30 inches or smaller. Keeping that ideal ratio will reduce your risk of disease — and increase your life expectancy.

To get an accurate waist measurement, don’t just measure where your pants sit — and avoid the urge to suck in your gut like you’re in a photo. Instead, relax, and start the tape measure just above one of your hip bones and below your lowest rib, keep it level at the belly button all the way around. You want the tape measure to be snug, but not compressing your body.

If the measurement is more than half of your height, use that as motivation. You can make smart choices, lose that harmful abdominal fat and give yourself a longer, healthier life in the process.

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Karen Cooper, DO

Karen Cooper, DO, Director of Be Well Moms℠ in the Women's Health Institute, is board-certified in family medicine and specializes in medical weight management.
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  • John R Shirley

    What is this measurement for a man. Does age make any difference?

    • Health Hub Team

      John, thank you for your question. Ideally when calculating the waist-to-height ratio, women should target between 36 and 49 percent, and men should target 36 to 53 percent. See the chart below for specifics. Age is not a factor. — Karen Cooper, DO

      • Ratio less than 35 percent: Abnormally Slim to Underweight
      • Ratio 35 to 42 percent: Extremely Slim
      • Ratio 42 to 46 percent: Healthy
      • Ratio 46 to 49 percent: Healthy
      • Ratio 49 to 54 percent: Overweight
      • Ratio 54 to 58 percent: Seriously Overweight
      • Ratio over 58 percent: Highly Obese

      • Ratio less than 35 percent: Abnormally Slim to Underweight
      • Ratio 35 to 43 percent: Extremely slim
      • Ratio 43 to 46 percent: Healthy
      • Ratio 46 to 53 percent: Healthy, Normal Weight
      • Ratio 53 to 58 percent: Overweight
      • Ratio 58 to 63 percent: Extremely Overweight/Obese
      • Ratio over 63 percent: Highly Obese


  • Natalie ._c-

    What this doesn’t take into account is that we are all built differently, regardless of the weight we are carrying. I happen to carry my weight around my belly (I’m female). And according to your chart, I have a waist-height ratio of 63% — severely obese, according to you. I did have a coronary artery spasm when I was 44, and therefore an angiogram — it was CLEAN! And I had one last year when I was 64, and guess what! CLEAN again. I do yoga, and can get down on the floor and comfortably do all the stretches and poses. I also have diabetes, but I’m NOT insulin-resistant. My total daily dose is about 35 units a day, and I take no oral medication. So don’t tell me I’m severely obese, because I’m not. I’m actually not obese at all. And to get to where you would deem me healthy would mean being anorexic, because I would literally have to be skin and bones, and eat nearly nothing in order to reach a ratio of less than 50%. And my PhD dietitian does not encourage that type of restricting (I already tried it). So it seems to me that your waist-height ratio is just as much garbage as the BMI, because again, it doesn’t take into account a person’s genetically determined build, nor whether the fat is subcutaneous or visceral. Mine seems to be mostly subcutaneous, and that may be why I don’t have the risk that your classification would indicate. Once again, I think you’re being simple-minded, and this issue is just not that simple.

    • Doug

      And you have these health issues because. …………..?

    • John Bafford

      Sorry but you’re wrong Natalie.. this does take into account that we are built differently hence why the BMI is a not a strong predictor but this IS a strong predictor. If you have a waist-heist ratio of 63%, this means you have a very large circumference when compared to your height. Your angio gram just means you have ‘clear’ arteries and it does not tell you everything. And according to this measurement, you are clearly obese.. There is no chance this is all muscle around your mid region.. it is mostly fat (subcutaneous). So yes, it can be lost and you can get down to where it is not considered obese. Do not use these lame excuses that your dietician tells you being thinner is bad for you.. that’s complete nonsense. Its not being anorexic to be at a healthy waist-height ratio.. you’re clearly just trying to hide the obvious..

    • Dillonvale1964

      Natalie… This ratio is a screening tool to ascertain risk, not to diagnose. It is basically saying that people with high ratios are at higher risk. Individual results may vary and nothing takes the place of personal consultations with a physician. I mean you no offense, but if your waste is 63% of your height, your risk is very high and you should be taking steps to lose weight with a healthy, well-balanced diet and regular exercise. If your nutritionist is telling you this is not necessary, you should consider getting a new one.

    • canrckid

      I am female and my waistline is smallest above the navel. Do I measure at the navel or at the smallest point between top of hips and bottom of ribs?

      • BobK

        measure where your torso creases when you bend sideways

    • cheryl mullen

      if you have diabetes that is a health issue that obesity causes wake up natalie

    • BobK

      Waist to height is WAY better than BMI by no means perfect but still WAY better.
      Waist to hip ratio is also a useful metric as is body fat %

      Waist to height can give a rough estimate of body fat %. Most women fall in the 5’2″ to 5’9″ range 63% would give waists of 39″ to 43″, WAY too large.
      Your nutritionist needs to get updated if they’re saying that 63% is ok. She / he has you eating whole grains & fruit and generally low fat foods??
      That’s a problem for obese people. Lose all sources of sugar & grains, lose the belly.


    Thank you for this