AUGUST 17, 2008 7:38PM

Does a 35-inch waist make you obese?

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A few months ago, I wrote a magazine article about a study that reported a troubling spike in strokes for women ages 35-54. The study seemed to indicate a link between abdominal obesity and strokes and other vascular events. But how do you define “abdominal obesity”? You might be surprised—and concerned.



Understanding abdominal obesity

My article noted that:

“The number of women aged 35 to 54 with abdominal obesity—meaning a waist size of about 34.5 inches or more—climbed from 47 percent to 59 percent … The average waist size for women increased about 1.5 inches.”

This definition of abdominal obesity provoked an e-mail from an upset reader:

“I … read your article on strokes. This topic is very serious, especially to us moms who strive to be healthy and active for not only our own well-being but for our children and family.

I am certainly not writing you to criticize in any way, just to get some explanation about some numbers you quoted in your article. I am an active, very athletic, regular runner, mother of 3, and very aware of my health, eating and exercise.  I was a bit alarmed at your statistic of what an obese abdomen is … I would love to know where you got that statistic, as I find it really hard to believe that a woman with a waist of only 34.5 has an obese abdomen. Mine is 33, I am a perfect, toned size 8, and you mean to tell me that I am only one-and-a-half inches away from being obese?  C’mon.

I am sorry to be so emotional about this, but I am not sure who sets these parameters for good health. That number has to be based on a few other things that maybe you didn’t mention, like height and weight? I just cannot believe that a single number like that can label someone as obese. That means most of the other moms in my subdivision are obese—can’t be!”

She’s right in a way—because abdominal obesity is not the same thing as overall obesity—but that doesn’t mean an expanding waist isn’t cause for concern.

The standard for abdominal obesity does indeed appear to be a waist size of 88 centimeters (or about 34.5 inches), which should worry the other moms in the subdivision. Studies suggest [registration required to access study] that “it is not how much fat a patient has, but where it is stored that contributes to overall cardiovascular risk, insulin resistance, and glucose tolerance.”

Health implications

One cardiologist I interviewed said abdominal obesity directly correlates with an increased risk for stroke and other manifestations of heart disease and peripheral vascular disease. He mentioned a study that found that, regardless of weight category (normal, overweight or obese), those with a “big gut” had:

  • higher blood pressure,
  • higher blood cholesterol levels,
  • lower HDLs (the good cholesterol), and
  • higher triglycerides.

Even if you don’t suffer from overall obesity, those are danger signs. “The bottom line is a big gut is bad for your health, regardless of whether you are of normal weight, overweight or obese,” the cardiologist said, “and this is especially so for women.”

And abdominal fat also has been linked to an increased risk of dementia in old age.

Reducing your waist size (and your stroke risk)

The doctors in my article gave the following advice:

1)         Exercise for at least one hour, five days a week, even if it’s just walking. As one internist said, “we are built to move, and, if we don’t, we will suffer those long-term health consequences.”

2)         Think not just about weight control but also waist control.

3)         Find a healthier lifestyle that includes a balanced diet and proper proportions of food.

4)         Don’t smoke.

5)         Consider the sources of your calories—reduce the consumption of white bread, pasta, white rice and white potatoes in particular, and replace them with fresher foods.

And, of course, read this blog for other health and fitness ideas!

*Note that the study was presented at the International Stroke Conference but had not yet been published in a peer-reviewed journal.

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I have a feeling the size 8 women was either measuring her waist too high or too low, or was not a size 8. With a 35 inch waist, a woman would more likely be over a size 20...
That's a great point--I'm never sure where to measure my waist, either!
I beg to differ about the 35 inch waist being over a size 20. I have a 33 inch waist (and yes, I am talking about my natural waist line, not where I would wear my pants). In pants, I wear about a size 14 to 16 depending on the maker and my hips are much wider than my waist. Regardless of anything, bodies come in all shapes and sizes. It's kind of hard to categorize everyone based off of some examples.
I'm also a 35" waist and I wear a size 10 in pants. Not all bodies are created equally. Could I stand to lose some gut, absolutely, but I don't think I am obese by any means.

I workout 4 times a week (cardio, kickboxing, and strength training) and am overall very active. Although I am not yet where I'd like to be scale-wise, I had my yearly physical about a month ago, and my bloodtests showed my heart and body are doing great.