What Is Waist-to-Hip Ratio?

Waist-to-hip ratio (WHR) is an alternative to body mass index (BMI) that may do a better job of identifying your risk of weight-related health outcomes. Having a higher WHR suggests that you also have higher levels of visceral fat, a dangerous type of belly fat that contributes to high blood pressure, heart disease, and type 2 diabetes.

Waist-to-hip ratio is the circumference of your waist divided by the circumference of your hips.

Having a higher WHR indicates that you have more weight around your abdomen and higher levels of visceral fat. This is a type of belly fat located deep under the abdominal muscles, surrounding organs like your stomach, liver, and intestines. Excess visceral fat can be dangerous to your health, increasing your risk of diabetes, heart disease, and stroke.

“Essentially, the wider the waist is and the closer in circumference to the hips, the more at risk one is for metabolic disease,” says Meghan Garcia-Webb, MD, a triple board-certified internal medicine, lifestyle medicine, and obesity medicine doctor in Wellesley, Massachusetts.

Having a lower WHR is associated with a lower risk of health conditions. “It typically means that a person carries less weight in their midsection relative to their hips,” says Nina Crowley, PhD, RDN, a nutritionist in Mount Pleasant, South Carolina. “Some people naturally carry more of their body fat in the lower body (hips and thighs), which isn’t associated with the same health risks as excess abdominal fat.” It doesn’t have the same health risks because the hips and thighs don’t contain vital organs, and fat in the lower body usually accumulates just below the skin.

Both Dr. Crowley and Dr. Garcia-Webb agree that having a smaller waist-to-hip ratio isn’t usually a cause for concern.

Health Risks Associated With a Higher Waist-to-Hip Ratio

If you have a high WHR, you may have an increased risk of certain health conditions, including:

High blood pressure
High cholesterol
High uric acid levels, which can contribute to gout, a type of inflammatory arthritis
Metabolic syndrome, a group of conditions that indicate a higher risk of diabetes, stroke, and heart disease
Colon cancer

Consider speaking with a doctor about ways to reduce your risk of these conditions if you have a WHR at or above 0.85 (for women) or 0.90 (for men).

The World Health Organization provides a simple cutoff for healthy and unhealthy waist-to-hip ratios:

When it comes to determing risk, it’s important to consider other factors too. “Health is more than just a number,” Crowley says. “WHR accounts for gender differences, but it does not take into account age or ethnicity, both of which influence metabolic health risks.”

A variety of research has suggested that the general WHR guidelines do not work equally well for people of every racial or ethnic background or at every stage of life.

Follow these steps for measuring and calculating your waist-to-hip ratio, Crowley says:

Make sure your have a flexible tape measure handy. Stand up tall and breathe out.
Use the tape measure to measure your waist at the narrowest part, typically just above the belly button, and your hips at the widest part, around the fullest point of your butt.
To calculate your WHR, divide your waist circumference by your hip circumference. For example, if your waist is 30 inches and your hips are 40 inches, your WHR is 0.75 (30 ÷ 40 = 0.75).

If you have a higher WHR, it doesn’t necessarily mean that you also have high levels of visceral fat, as the measurement doesn’t indicate what kind of fat is being stored around your abdomen, Garcia-Webb says. To assess your risk of certain health conditions, speak with your doctor, who may order additional testing.

“If you’re not sure if you have more subcutaneous (surface level) or visceral fat (deep fat next to your internal organs), a DEXA (bone density) scan will give you a more accurate assessment of body composition. But usually if people have abdominal obesity, they have more visceral fat than is healthy, regardless of how much subcutaneous fat there is,” Garcia-Webb says.

Some health experts are promoting the use of WHR because it addresses one of the major flaws with body-mass index, the biomarker that has traditionally been used to define if a person is overweight or has obesit y.

“BMI has been widely used, but it doesn’t differentiate between muscle and fat or show where fat is stored in the body,” Crowley says. It may produce skewed results for some people, particularly those who do strength training, bodybuilding, or otherwise have a lot of muscle. For example, a muscular, 6-foot-5 heavyweight boxer who weighs 264 pounds may have a BMI over 30, meaning they’d qualify as obese, according to BMI guidelines.

“WHR is often considered a better indicator of health risks because carrying excess weight around the waist is more strongly linked to metabolic diseases than carrying weight in other areas,” Crowley says. BMI, on the other hand, doesn’t differentiate between harmful visceral fat around your waistline and subcutaneous fat, or the less harmful fat found on other parts of your body like your thighs, butt, and arms.

While both BMI and WHR can be useful tools, they’re best when used together and discussed with a doctor. “A patient who has both an obese BMI and abdominal obesity is going to be at higher risk of weight-related health issues,” Garcia-Webb says.

“Ethnicity, genetics, and body type all influence fat storage and health risks,” says Crowley. “For the best understanding of health, body composition analysis — which assesses fat mass, muscle mass, and key metabolic markers — is far more useful than relying on either WHR or BMI alone.”

If you’re concerned about your health risks or any other variables that may contribute to your disease risk, it’s important to talk with your doctor.

To get rid of visceral fat and lose weight, you’ll want to combine aerobic activity, such as running or walking, with strength training and a balanced diet. Abdominal exercises like sit-ups can help tone and tighten your waistline, but they can’t spot-reduce visceral fat.

Your doctor may also be able to recommend lifestyle changes or other treatments to improve your overall health.

Making dietary changes and exercising are always good first steps toward adjusting your WHR, Crowley says. “Including healthy fats, such as omega-3s from fish and nuts, may reduce inflammation linked to metabolic dysfunction. Exercise plays a crucial role, with strength training helping to build muscle and boost metabolism, and moderate to high-intensity cardio may help reduce visceral fat.”

Your mental health can play a role in how your body stores visceral fat too. “Chronic stress increases cortisol levels, which can promote fat storage in the abdomen, making mindfulness, deep breathing, and relaxation techniques valuable strategies,” Crowley says.

In addition, poor sleep is linked to weight gain and an increase in visceral fat. When you’re tired, you’re likely to eat more and reach for less-healthy options, causing you to take in more calories. “Prioritizing quality sleep is essential for hormonal balance and long-term weight regulation,” Crowley says. Health experts typically recommend seven to nine hours of sleep each night for most adults.

In some cases, an underlying health condition can be the cause of excess weight around the abdomen. “Certain medical issues may present with a higher waist-to-hip ratio, such as Cushing syndrome,” Garcia-Webb says. “Postmenopausal women will generally have a slightly higher waist-to-hip ratio than premenopausal women, due to hormonal changes, but the goal is still to keep it below 0.85.”

If you’re having difficulty reducing your WHR, talk with your doctor. They may ask about any other symptoms you’re experiencing and suggest testing to get to the root of what may be contributing to excess weight.

Waist-to-hip ratio, or WHR, measures the ratio of your waist size to your hip size, which does a better job of estimating how much visceral fat you carry in your midsection than traditional measurements like BMI.
A higher WHR is associated with an increased risk of chronic diseases such as metabolic syndrome, heart disease, and diabetes.
For women, a WHR at or above 0.85 indicates a higher risk, while for men, a WHR at or above 0.90 may indicate increased risks.
You can’t change your body shape, and it’s not easy to target weight loss in your belly, but a healthier diet, exercise, and lifestyle choices can help reduce your risk of chronic conditions.

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Health Risks Associated With a Higher Waist-to-Hip Ratio