For decades, we’ve relied on the bathroom scale to tell us whether we’re maintaining a healthy weight, but health experts are increasingly encouraging people to look beyond kilograms and pay closer attention to your waist circumference, which could be a better indicator of your metabolic health.
Growing scientific evidence suggests that carrying excess fat around the abdomen, often referred to as visceral fat, is more strongly associated with insulin resistance, type 2 diabetes (T2D) and cardiovascular disease (CVD) than body weight alone. Waist circumference also provides additional information beyond Body Mass Index (BMI) and is increasingly being recognised as an important “vital sign” in clinical practice.
The message is particularly relevant in South Africa, where the burden of metabolic disease continues to grow. An estimated 4.7 million South Africans are living with diabetes, the vast majority with type 2 diabetes, while millions more remain undiagnosed or are at high risk of developing the disease. This risk is further compounded by high obesity rates, with approximately 31% of men and 68% of women in South Africa classified as obese.
Unlike the fat stored just beneath the skin, visceral fat surrounds internal organs and is metabolically active, producing stress hormones, inflammatory molecules, and fatty acids that may contribute to chronic disease. Waist circumference is a quick, inexpensive screening tool that can help identify people at increased risk of metabolic syndrome, a cluster of conditions, including elevated blood sugar, high cholesterol, high blood pressure, and excess abdominal fat, that significantly increases the risk of T2D and CVD.
Many people are reassured when the number on the scale doesn’t change very much, but that’s not always the full story. Where fat is stored can be just as important as how much we weigh. Measuring your waist is a quick, inexpensive habit that can help people identify potential metabolic risk earlier. Waist circumference should be viewed as another simple health check people can do at home alongside monitoring their weight.
Prevention starts with awareness, and if people begin noticing their waistline increasing over time, it gives them the opportunity to make lifestyle changes before more serious health problems develop.
More than weight loss
Reducing waist circumference isn’t simply about appearance; it reflects improvements in metabolic health. People often think the goal is to lose weight, but the bigger goal is improving metabolic health. Even modest reductions in abdominal fat can improve insulin sensitivity and reduce the risk of developing chronic diseases.
Research shows that regular physical activity, a balanced eating pattern rich in vegetables, whole grains, legumes, and lean protein, adequate sleep, stress management, limiting alcohol intake, and avoiding smoking all contribute to reducing abdominal fat and improving metabolic parameters. Early screening can identify elevated blood glucose and other risk factors before symptoms appear, giving people a valuable opportunity to intervene early.
Where do supplements fit in?
Lifestyle modification remains the cornerstone of preventing and managing metabolic disease. However, under the guidance of a healthcare professional, some people may also consider evidence-based nutritional supplements as part of a broader management plan. While findings are encouraging in some studies, these ingredients should complement, not replace, a healthy diet, regular exercise and appropriate medical care.
Take the one-minute challenge
The Waist Wise campaign encourages everyone to spend just one minute each month measuring their waist.
Here’s how:
- Stand upright and breathe out normally.
- Place a tape measure around your abdomen midway between the bottom of your ribs and the top of your hip bones.
- Ensure the tape is snug, but not compressing the skin.
- Record your measurement each month and watch for upward trends.
- If your waist circumference is increasing or exceeds the recommended threshold (more than 94 cm for men and 80 cm for women), discuss your results with your healthcare provider.
A tape measure costs very little, takes less than a minute to use, and can provide valuable insight into your metabolic health. It’s one of the simplest habits people can adopt to help identify potential health risks before they become serious.
