As South Africa grapples with rising rates of obesity and type 2 diabetes, health experts are urging people to look beyond their weight and pay closer attention to where they carry excess fat, particularly around the abdomen.
Growing evidence suggests that abdominal fat, especially visceral fat stored around the internal organs, is associated with metabolic problems such as insulin resistance, type 2 diabetes and cardiovascular disease.
That means stepping on a scale may not give South Africans the full picture of their metabolic health.
An estimated 4.7 million South Africans are living with diabetes, according to figures cited by Pharma Dynamics, with many more thought to be undiagnosed or at high risk of developing the condition.
Obesity is also a major concern, with approximately 31% of South African men and 68% of women classified as either overweight or obese, according to the figures supplied by the company.
Against this backdrop, waist circumference is being promoted as a simple measurement that could help people identify whether they may need to take a closer look at their metabolic health.
Your BMI doesn’t tell the whole story
Body mass index, or BMI, has long been used to assess weight in relation to height. But it has an important limitation: it does not show where fat is stored. Someone can have a BMI within the “normal” range while carrying excess abdominal fat.
Visceral fat is different from the fat stored just beneath the skin. It surrounds internal organs and is metabolically active, releasing substances that can contribute to inflammation, insulin resistance and other metabolic disturbances. This can increase the risk of conditions including type 2 diabetes and cardiovascular disease.
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“Many people are reassured when the number on the scale doesn’t change very much, but that’s not always the full story,” says Helena Westwood, Associate Director for Consumer Brands at Pharma Dynamics.
“Where fat is stored can be just as important as how much we weigh.”
Waist circumference is a quick and inexpensive screening measurement that can provide an indication of increased metabolic risk. According to the thresholds cited by the International Diabetes Federation and supplied by Pharma Dynamics, men with a waist measurement of 94cm or more and women with a measurement of 80cm or more may be at increased risk of metabolic health problems.
However, these figures should not be treated as a diagnosis. Having a waist measurement above a threshold does not mean someone has diabetes or heart disease. Rather, it can be a reason to have their overall risk assessed by a healthcare professional.
This is particularly relevant for people with other risk factors, including a family history of diabetes, high blood pressure, abnormal cholesterol or cardiovascular disease.
Don’t wait until you feel sick
Conditions such as type 2 diabetes and high blood pressure can develop without obvious symptoms, making prevention and early screening important. A steadily increasing waistline can be one reason to take stock of your lifestyle and consider having your blood pressure, blood glucose and cholesterol checked.
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“Prevention starts with awareness,” says Westwood. “If people begin noticing their waistline increasing over time, it gives them the opportunity to make lifestyle changes before more serious health problems develop.”
The focus on waist circumference should not become another obsession with appearance or weight loss. The bigger goal is metabolic health.
Regular physical activity, a balanced eating pattern rich in vegetables, whole grains, legumes and lean sources of protein, adequate sleep and stress management can all support better metabolic health.
Limiting alcohol and avoiding smoking
“People often think the goal is to lose weight, but the bigger goal is improving metabolic health,” says Westwood, adding that even modest reductions in abdominal fat can improve insulin sensitivity and reduce the risk of developing chronic diseases.
Measure your waist in one minute
Keeping track of your waist circumference does not require expensive equipment or a gym membership. All you need is a tape measure.
Here’s how:
1. Stand upright and breathe out normally.
2. Place the tape around your abdomen midway between the bottom of your ribs and the top of your hip bones.
3. Make sure the tape is snug but does not compress your skin.
4. Record the measurement.
5. Repeat the measurement regularly and look for an upward trend.
If your waist circumference continues to increase, or is above the recommended threshold, speak to a healthcare professional about your overall risk.
- Approximately 4.7 million South Africans are living with diabetes, with many more undiagnosed or at high risk, according to Pharma Dynamics.
- Around 31% of South African men and 68% of women are classified as overweight or obese.
- Waist circumference is promoted as a simple measurement to indicate increased metabolic risk, with 94cm in men and 80cm in women cited as thresholds by the International Diabetes Federation.
- Visceral fat around internal organs contributes to inflammation and insulin resistance, increasing the risk of type 2 diabetes and cardiovascular disease.
- Measuring waist circumference regularly can help individuals monitor metabolic health and prompt earlier assessment by healthcare professionals if measurements increase or exceed thresholds.
