Diabetes & Stoffwechsel
Weight is not the only factor that matters: where body fat is stored can be relevant for the metabolism. In this context, the abdominal circumference provides simple, additional information.
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✨ Key Information at a Glance
Abdominal fat is metabolically not the same as fat directly under the skin.
Waist circumference complements weight and BMI with information on fat distribution.
A larger waist circumference may be associated with a higher risk of metabolic and cardiovascular diseases.
The overall assessment, including blood pressure, blood sugar, blood lipids, pre-existing conditions, and personal situation, is decisive.
Why is abdominal fat important for the metabolism?
It is not only the overall weight that is decisive, but also where the body stores fat. Fat deep inside the abdominal cavity (visceral fat) is more metabolically active than fat directly under the skin.
An increased accumulation of fat in the abdominal cavity can be associated with impaired glucose processing or insulin resistance, elevated blood pressure, unfavourable blood lipid levels, and a higher risk of cardiovascular diseases. This does not mean that every person with abdominal fat has these conditions – it concerns a risk that is always assessed on an individual basis.
Weight alone does not tell the whole story
BMI: provides guidance based on body weight and height.
Waist circumference: supplements information on fat distribution in the abdominal area.
Consider together: none of the values should be interpreted in complete isolation.
Current European specialist frameworks recommend looking beyond BMI and including fat distribution in the assessment.
How to measure waist circumference correctly
Stand upright.
Guide the measuring tape horizontally around the abdomen.
Measure approximately midway between the lower costal margin and the upper iliac crest.
Breathe out normally and do not constrict the measuring tape.
Which values are relevant depends, among other things, on sex, origin, and the overall medical situation. A single general number does not fit everyone.
Waist-to-height ratio
The ratio of waist circumference to height can also provide additional information about fat distribution and metabolic risk.
Abdominal fat & metabolism
🩸 Blood sugar: insulin resistance, pre-diabetes, or diabetes can be part of the overall assessment.
❤️ Blood pressure: overweight and abdominal fat distribution can occur alongside high blood pressure.
🧪 Blood lipids: cholesterol and triglycerides can be relevant depending on the situation.
📈 Progress: changes over time are often more meaningful than a single measurement.
Abdominal fat and pre-diabetes
Abdominal fat distribution can be linked to insulin resistance and an increased risk of pre-diabetes. More on pre-diabetes →
What can be influenced?
Nutrition: long-term feasible changes instead of short-term diets.
Exercise: regular physical activity supports metabolism and health.
Weight development: the progress alone provides important information.
Medical support: in the case of increased risk or co-morbidities, a medical assessment may be useful.
In children and adolescents
In children and adolescents, growth, age, and sex are taken into account. Adult limit values cannot simply be applied.
In older age
In older age, muscle mass, strength, nutritional status, and functional health are important in addition to weight and waist circumference.
Medical weight management
In the case of overweight, obesity, or metabolic risk factors, weight, waist circumference, blood pressure, laboratory values, and personal goals can be considered together. More on weight management →
⚠️ When should I consult a General Practitioner?
A medical assessment may be useful in the event of:
significant or increasing weight gain,
simultaneously elevated blood sugar or prediabetes,
high blood pressure,
abnormal blood lipids,
strongly increasing abdominal circumference,
other complaints or pre-existing conditions that require medical assessment.
The abdominal circumference alone does not constitute a diagnosis and is always assessed in the overall context.
Sources
European Association for the Study of Obesity (EASO), 2024
Busetto L, Dicker D, Frühbeck G, et al. A new framework for the diagnosis, staging and management of obesity in adults. Nature Medicine. 2024.
European Society of Cardiology (ESC), 2024
Obesity and cardiovascular disease: an ESC clinical consensus statement. European Heart Journal. 2024.
European Society of Endocrinology
Clinical Practice Guideline: Endocrine work-up in obesity.
World Health Organization (WHO)
Waist circumference and waist–hip ratio: report of a WHO expert consultation.
💡 Take-home Message
It is not only body weight that matters. Waist circumference can provide additional information regarding fat distribution and metabolic risk – however, a comprehensive medical assessment is always the decisive factor.
Medical Advice
The information on this website is intended for general guidance only and does not replace an individual medical consultation, examination, or diagnosis. In the event of symptoms or health-related questions, please consult your physician.
🧭 What are the next steps?
1
Understand medical report
2
Assess your personal risk
3
Set individual goals
4
Monitor progress
5
If needed, plan treatment together
👵 In advanced age
Treatment goals and therapies are individually tailored to your personal situation.
Concomitant diseases
Medications
Mobility
Memory / Cognition
Self-employment (Selbstständigkeit)
Therapeutic safety
Therefore, in older age, different treatment goals may be appropriate than for younger individuals.
Source: Austrian Diabetes Society — Geriatric Aspects of Diabetes Mellitus (2026 Update)
Children & Adolescents
For the diagnosis of diabetes, the same threshold values generally apply as for adults.
However, clarification, care, and therapy must be carried out in an age-appropriate and family-friendly manner.
In the case of abnormal values, a pediatric or pediatric-diabetological evaluation is recommended.
Source: Austrian Diabetes Association (Österreichische Diabetes Gesellschaft) — Diabetes Mellitus in Childhood and Adolescence (Update 2026)
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Medically reviewed by
Dr. med. Shahzada Amir, MSc, PhD