Waist circumference as a vital sign in clinical practice: a Consensus Statement from the IAS and ICCR Working Group on Visceral Obesity

Robert Ross, Ian J Neeland, Shizuya Yamashita, Iris Shai, Jaap Seidell, Paolo Magni, Raul D Santos, Benoit Arsenault, Ada Cuevas, Frank B Hu, Bruce A Griffin, Alberto Zambon, Philip Barter, Jean-Charles Fruchart, Robert H Eckel, Yuji Matsuzawa, Jean-Pierre Després

Research output: Contribution to JournalReview articleAcademicpeer-review


Despite decades of unequivocal evidence that waist circumference provides both independent and additive information to BMI for predicting morbidity and risk of death, this measurement is not routinely obtained in clinical practice. This Consensus Statement proposes that measurements of waist circumference afford practitioners with an important opportunity to improve the management and health of patients. We argue that BMI alone is not sufficient to properly assess or manage the cardiometabolic risk associated with increased adiposity in adults and provide a thorough review of the evidence that will empower health practitioners and professional societies to routinely include waist circumference in the evaluation and management of patients with overweight or obesity. We recommend that decreases in waist circumference are a critically important treatment target for reducing adverse health risks for both men and women. Moreover, we describe evidence that clinically relevant reductions in waist circumference can be achieved by routine, moderate-intensity exercise and/or dietary interventions. We identify gaps in the knowledge, including the refinement of waist circumference threshold values for a given BMI category, to optimize obesity risk stratification across age, sex and ethnicity. We recommend that health professionals are trained to properly perform this simple measurement and consider it as an important 'vital sign' in clinical practice.

Original languageEnglish
Pages (from-to)177-189
Number of pages13
JournalNature Reviews. Endocrinology
Issue number3
Early online date4 Feb 2020
Publication statusPublished - 2020


The authors acknowledge the financial support of the IAS and the ICCR, an independent academic organization based at Université Laval, Québec, Canada, who were responsible for coordinating the production of our report. No funding or honorarium was provided by either the IAS or the ICCR to the members of the writing group for the production of this article. The scientific director of the ICCR (J.-P.D.) is funded by a Foundation Grant (Funding Reference Number FDN-167278) from the Canadian Institutes of Health Research.

FundersFunder number
Canadian Institutes of Health Research
International AIDS Society
International Chair on Cardiometabolic RiskFDN-167278


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