Whittle That Middle: A Trimmer Waistline Improves Your Health

Most of us are familiar with the facts around obesity: More than one-third (more like 35%) of American adults are obese. For a while, we were encouraged because according to the National Health and Nutrition Examination Survey, or NHANES, the prevalence of obesity based on body-mass index (BMI) did not change significantly between 2003–2004 and 2011–2012. Researchers and health experts breathed a small sigh of relief after learning that: Maybe all the messaging, education, and efforts to help people reach and stay at a healthy weight really were paying off.


Not so fast. Last week, the Journal of the American Medical Association featured a rather grim article on the state of the U.S. waistline. While BMI may not be changing much, we still have a bit of a problem. Abdominal obesity and the average waist circumference in U.S. adults actually increased from 1999–2012.

What is waist circumference?
Your waist circumference is basically your waist size, or the distance around your waist. For most people, an increasing waist circumference means that it’s either time to cut back a bit on the portions or else buy a larger clothing size. For health-care professionals, an expanding girth is a warning of possible health issues, including metabolic syndrome, Type 2 diabetes, heart disease, and cancer. And “thin” people aren’t necessarily off the hook either; the typical “apple-shaped” person with thin arms and legs but a wide middle is also at risk for health problems.

Why is waist circumference increasing?
That’s a very good question. You’d think that, with all the different ways to lose weight, healthy foods, fitness centers, and walking paths we have available, waist circumference wouldn’t be an issue, right? Well, you and I know it’s not that easy. Losing weight can be hard, healthy foods can be costly, and finding safe and inexpensive places to exercise can be challenging for many people. But the researchers who published the study I mentioned above think that other factors are part of the problem. These include lack of sleep, endocrine disruptors (chemicals that can interfere with hormones), and certain medicines.

How is waist circumference measured?
No fancy equipment is needed to measure your waistline. Your basic tape measure will do the trick. However, obtaining an accurate waist measurement is a bit tricky. Ideally, it’s best if a trained health-care professional does this for you. All too often, people don’t place the tape measure on the right spot, or they “cheat” a bit by sucking in their stomach. The tape measure should be placed right above your hip bones in line with your navel and the measurement taken after you breathe out. Ask your doctor to check your waist circumference and then make a note of it, just as he would with your weight, your A1C, or your blood pressure.

What should your waist circumference be?
If you’re a man, your waist should measure less than 40 inches; if you’re a woman, it should be less than 35 inches.

How can your whittle your middle?
Whatever you call it — a spare tire, abdominal obesity, an apple shape, or increased visceral fat, there are two things you should know about a larger-than-desired waistline: 1. It’s something to pay attention to because it poses a danger to your health, and 2. You really can trim your waistline.

Unfortunately, there are no quick fixes to shrink your tummy. I’ve written about this before, but the bottom line is that you’re not doomed to have an ever-expanding waist. Here’s what can help “whittle that middle”:

Exercise. Aim for at least 30 minutes, most days of the week. Walking is doable for most people, especially if you’re not inclined to head to a gym. But other types of exercise count too, including exercise bikes and using armchair videos if you’re not able to stand or put weight on your feet. What about those targeted ab exercises, like crunches? They’ll help tone your abdominal muscles, but they won’t burn the visceral fat that lurks beneath those muscles.

Eating wisely. Skip the crash diets and juice fasts. They don’t lead to permanent weight loss. But you might aim for a slightly higher-protein diet. Include a protein food, like eggs, turkey breast, or low-fat cottage cheese, for example, at each of your meals. Skip the refined carb foods, such as white bagels, white rice, sugary cereals, and chips. Increase your soluble fiber intake from foods such as beans, apples, oatmeal, flaxseed, and nuts.

Get enough sleep. You really do need about 7–8 hours, on average, of sleep each night. Shortchanging yourself on sleep may give you more time in your day to get things done, but it can wreak havoc on your health…and your waistline.

Deal with stress. We all have stress, but it’s how we manage it that really counts. There are a lot of things that you can do if stress is a constant in your life, including deep breathing, exercising, meditating, doing yoga, or seeking professional help.

Check your medicines. Some medicines can make it harder to lose weight. You shouldn’t stop taking any medicine without talking with your doctor first. But you can review your meds at your next doctor’s visit and if any are “weight unfriendly,” there may be other options to try.

Keep tabs on your waistline. Talk to your doctor about it and ask that he measures it as part of your regular visits.

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  • Valerie

    my husband has been fighting illness for quite a few years and thank God he is coming around. He had kidney stones and when they blasted the first one he got a blood clot so that had to be treated as well as having Hep C and diabetes – he has finish the amazing new Hep C treatment with Solvaldi and Interferon and Ribivarin and thank GOD he is Hep C FREE – They had to remove his gall bladder and they did a biopsy of his liver and all looks good but they said he had at one point had pancreatitis – so I they are going to keep an eye on it but everything looks ok – Now after all that back story would any of that have an affect on his type II diabetes – right now he is on metformin and glimepiride – and just can’t seem to get it under 127 – why? We have been on a diet for approximately a year – originally cut out all dairy, oil, meats, and anything white – we are slowing adding Good oil and small amounts of meat as organic as possible. Please advise what we should do. His doctor is not helpful just want to throw in more medicine – I don’t like the meds – they make you gain weight.

  • A. Campbell

    Hi Valerie,

    I’m glad that your husband is doing better. He’s certainly been through a lot! It’s possible that some of his health issues could have affected his diabetes control, especially if he was given steroids at any point. But it’s also important to realize that diabetes can naturally change over time; it’s very common for diabetes to “progress.” That doesn’t mean that nothing can be done. As he’s doing, watching one’s diet and getting regular exercise are key. You’re probably aware of this, but it’s important to control all sources of carbohydrate, not just “white” carbs. That doesn’t mean he should stop eating them, but controlling portions is important. Consider meeting with a dietitian for more specific nutrition guidance. Also, hopefully he feels well enough to do some physical activity, ideally, every day. Finally, in some cases, more or different diabetes medicine may be needed. There are newer medicines that don’t cause weight gain, so if his doctor is encouraging more meds, make sure that he discusses his options.

  • CalgaryDiabetic

    How to trim your waist line ? I have tried everything including cutting insulin a lot and letting the BG go higher. This helps somewhat.