Is waist to height ratio better than BMI?
For some things, and the honest version is narrower than the claim you usually read. It catches central fat in people whose BMI sits in the normal range, it needs no separate cutoffs by ethnicity, and it works on someone carrying a lot of muscle, which is exactly where BMI misleads.
For predicting death, the evidence does not support superiority. The largest recent prospective test, 94,401 people followed with 48,323 deaths, found waist to height performing at a similar magnitude to BMI and to waist circumference alone.
The practical answer is to stop treating it as a contest. Run both. BMI is what your medical records will carry and what most guidelines still start from. Waist to height catches the people BMI misses. If one of them looks bad, take that one seriously.
Source: Patel et al, waist to height ratio and cause-specific mortality, PLOS ONE 2025
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Answered by the AskDoc Medical Team · Medically reviewed under our Medical Director, MBBS · How we review
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