Waist-hip ratio and fat distribution - does it matter?

Bella_Figura

I'm curious...

I've always carried a lot of weight around my midriff- I'm the quintessential apple shape. I guess genetics plays a role in fat distribution.

Having lost 36kg, I've reduced my BMI from 41 to 25.2, so I'm on the cusp of a 'normal' BMI. However, I still have lots of fat around my midriff. Not just loose skin...genuine pinch-an-inch (or five inches) subcutaneous fat.

Cosmetically, I'm not bothered. Only my husband sees me naked, and it doesn't stop me wearing skin tight lycra on my road bike or from wearing a bathing suit on the beach. I have plenty of loose skin on my arms, belly and inner thighs and I'm sanguine about it. But the residual spare tyres of fat have surprised me.

Given the health warnings about belly and visceral fat, is this something I can safely ignore? Will the fat redistribute in time? If not, should I push on and lose more weight? I'd estimate there's at least 10kg of fat there, but I didn't intend to go that low (it would make my BMI around 22.5). The rest of me is pretty lean, especially my legs and upper body. I'm happy with the way I look in clothes, and I don't aspire to being skinny...

I don't do any strength work, but I cycle about 300kms a week, walk about 15,000 steps a day at a brisk pace, and I've just started hula hooping for about 15-30 minutes a day (though for fun, not for body composition purposes).

If midriff fat isn't innately unhealthy, I'll accept it happily, But if it's in my health interests to lose it, then I guess I'll keep plugging away at the weight loss.

sijomial

Yes - waist / height ratio and carrying a lot of fat around the mid-section is a health risk factor.


From the NHS:
"Why waist size also matters
Measuring your waist is a good way to check you're not carrying too much fat around your stomach, which can raise your risk of heart disease, type 2 diabetes and stroke.

You can have a healthy BMI and still have excess tummy fat, meaning you're still at risk of developing these conditions.

To measure your waist:

Find the bottom of your ribs and the top of your hips.
Wrap a tape measure around your waist midway between these points.
Breathe out naturally before taking the measurement.
Regardless of your height or BMI, you should try to lose weight if your waist is:

94cm (37ins) or more for men
80cm (31.5ins) or more for women
You're at very high risk and should contact a GP if your waist is:

102cm (40ins) or more for men
88cm (34ins) or more for women"

But these are generic population risk factors and you will have personal risk factors than might influence your personal outcomes and risk levels....
e.g. Being very fit is a positive for your heart health, your genetics have a big bearing on developing T2D (no-one in my extended family have been diabetic, even the fat ones!).

As a fellow cyclist a better power to weight ratio would give a performance benefit to losing some weight/fat.

Bella_Figura

Thanks @sijomial
My waist is currently 79 cm... so pretty high for someone who's only 1.55m tall. I also have a big spare tyre of subcutaneous fat between my waist and my boobs, as well as an apron of fat at navel level. My waist/hip ratio is 0.83. My dad and elder sister both developed T2D in their 60s. I have insulin resistance but I'm not pre-diabetic. I'm pretty fit and healthy (a minor miracle given my lifetime of obesity). At the moment my power average is 2.2 w/kg, so losing some weight without sacrificing power would improve that.

My motivation for asking the question is health - I'm influenced more by gut instinct rather than BMI charts, and my gut instinct tells me that carrying such a grabbable amount of fat around my midriff shows that there's work still to be done and a not-insignificant amount of weight still to be safely lost.

So much as I'd like to consider the weight loss stage 'done and dusted' and move fully into maintenance, I think I'd be wise not to bury my head in the sand about this very visible indicator that I'm still carrying excess fat.

AnnPT77

Just some observations about my personal experience that may or may not apply to you:

At BMI 25, I was still over-fat. That won't be true for everyone, but statistics suggest it's probable for most women (still not all). I don't have dramatically low muscle mass, either - it's higher than average for my demographic, probably average-ish if I were younger and reasonably active. I have wide shoulders, big head, big hands/wrists, but fairly narrow pelvis (and no breasts - but they were small even when I had them).

By the time I got to around BMI 25 (150 pounds at 5'5"), I was also looking pretty thin on some parts of my body (upper rib area, for example). But fat loss doesn't happen evenly all over one's body the whole way through loss, right? I'm sure you've observed that already. Once I didn't have much fat in one area, I wasn't going to keep losing fat in that area (because there wasn't much/any), I was going to lose it - eventually - from where my body was still keeping it. And I did.

Some people here have told me they wouldn't like to be as thin as I am (BMI 21-22 area most of the time) because of that bony chest area. That's their call. Even at that BMI, I can still pinch a bit in my midsection (not bunches, but a couple of inches). There's still fat on my body. I just don't get to arrange it where I might prefer for it to be.

I can't say how you will be, but I'm healthier and feel better at BMI 21-22 than at BMI 25. I'm also performing better competitively in my age class (though no longer actually competing) as a rowing lightweight (<135 pounds) than I would as an openweight.

These things are really individual: Body shape matters, body composition matters, family health history and genetics matter, and more. Some people prioritize appearance, some health, some performance.
You didn't mention it, but there's also the question of where one can maintain happily on the maintenance calorie budget.

Also, just as a random observation to throw into the discussion, there's reportedly a difference in health impact between visceral fat and belly fat, in the sense that visceral fat is interior to the body cavity, around the organs, and is reportedly more health-risky than subcutaneous non-visceral belly fat. Either can increase waist circumference, IMU, but I doubt we can much pinch visceral fat.

That said, I suspect you're right, that if you still have grabbable subcutaneous midsection fat, you probably still have fat you can safely lose. If you have the option, getting one of the more adequate types of body composition evaluation (like DEXA), if available and affordable, would give you more concrete information. I'm not saying I think that's essential (I don't): I think self-perception is a fine guide, in a person without serious body dysmorphia, and you don't seem biased in that way.

But I ramble. It sounds like you maybe know what you'd prefer to do.

sijomial

I think your conclusion sounds spot on.
The BMI range is so wide to cater for many different body shapes and builds and determining where our personal best part of the range sits does take some reflection, especially if we have been overweight for a while. My initial goal weight also turned out to be too high and I adjusted downwards in a series of small steps of weight loss and maintenance.

Bella_Figura

Thanks @AnnPT77 - really helpful as usual.

One of the reasons I wasn't keen on getting to the low 20s in BMI terms was the impact on calorie budget - I like my grub! At my current average activity factor, reducing from 60kg to 54kg (BMI 25 to 22.5) lowers my TDEE by around 100 calories a day. Pushing further to 50.5kg (BMI 21) would lower my TDEE by a further 59 calories a day to around 1,725 calories. So not intolerable, but obviously something to take into consideration, especially since that TDEE is fuelled by quite a lot of intentional exercise, which is obviously dependent on remaining uninjured and healthy.

I don't think I suffer from body dysmorphia - this is definitely 'grabbable' fat (by the large handhold!) rather than paranoia. I'm actually more concerned about residual visceral fat, and I guess I'm assuming the subcutaneous fat is a proxy for the hidden visceral fat...I'm making the assumption that I also still have too much visceral fat but I just can't see it. Of course my visceral fat may have all melted away, but in the absence of a proper scan I'll never know for sure.

One day I may go down the scan route, but for the time being I think I'll forge ahead (slowly but surely) to a lower weight and BF percentage than I'd originally intended. I'm in no rush...I'll just chip away at the remaining kilos and stop when I feel that enough's enough. I have a feeling, though, that I won't reach that goldilocks sweet spot until my BMI's around 22.5...

AnnPT77

As a very active person - presumably with some extra muscularity as compared to an inactive one even without explicit strength training - you may get some positive surprise in your final TDEE, too . . . even if you're calculating it off your loss rate, but especially if you're believing a fitness tracker or calorie calculator and not verifying against your own logging/loss data.

Not true for everyone, but it's not super unusual for people to see maintenance calorie needs creep up a bit after a few weeks or so at estimated maintenance calories - adaptive thermogenesis in the "get to eat more" direction, among other possible factors.

Bella_Figura

I hope you're right @AnnPT77! My TDEE is calculated off my loss rate (with over 500 consecutive days of accurate tracking) and the activity factor has remained pretty constant since the beginning, but I'm willing to have a pleasant surprise...just hoping it's not an unpleasant surprise instead!

TicTacToo

I'm glad to hear you're not too bothered about BMI, OP... if someone gains 1kg of muscle and loses 1kg of fat then their BMI stays the same although they would now be leaner and healthier. Sounds like you're more interested in body recomp now?