Physical examination maneuver

Physical Exam

Waist-to-hip Ratio

🔒
Subscribe to view — from $5/moSign in to watchAlready a subscriber? Videos are for subscribers. Subscriptions are not available in the app.At a school or residency?

How to Perform

With the patient standing, expose the waist landmarks by lifting the shirt and lowering the waistband slightly. Have the patient stand upright with the feet together, arms relaxed at the sides, and abdomen relaxed. Using a flexible, nonstretchable tape, measure the waist circumference directly on skin at the midpoint between the lower margin of the last palpable rib and the top of the iliac crest. Keep the tape horizontal and snug without compressing the skin, and record the measurement at the end of a normal expiration. Then have the patient slide the pants down to the upper thighs and measure the hip circumference over the underwear around the widest portion of the buttocks, keeping the tape horizontal and snug without compressing the underlying tissue. Record both measurements in the same units and calculate the waist-to-hip ratio by dividing the waist circumference by the hip circumference.

How to Interpret

Showing 4 of 5 findings

Cardiovascular Disease

Elevated waist-to-hip ratio in men
Rule in
Minimally helpfulDerived CI
Rule out
Minimally helpfulDerived CI
Evidence:Moderate
Elevated waist-to-hip ratio in women
Rule in
Minimally helpfulDerived CI
Rule out
Minimally helpfulDerived CI
Evidence:Moderate

Metabolic Syndrome

Elevated waist-to-hip ratio in men
Rule in
Somewhat helpfulDerived CI
Rule out
Somewhat helpfulDerived CI
Evidence:Moderate

Visceral Adiposity

Elevated waist-to-hip ratio
Rule in
Somewhat helpfulDerived CI
Rule out
Somewhat helpfulDerived CI
Evidence:ModerateResearch in progress

Related Bedside Tests

🎬Video coming soon
Blood Pressure
Rule in:VHHypovolemia, VHMortality, VHStructural Brain Lesion +22 more
Rule out:VHCardiac Tamponade, VHHypovolemia, HLow Cardiac Output +22 more
Waist CircumferenceMembers
Sign in
Waist Circumference
Rule in:HObesity
Rule out:SHObesity
🎬Video coming soon
Edema Assessment
Rule in:SHAscites, SHCirrhosis, SHCushing Syndrome +14 more
Rule out:HAscites, MHHeart Failure, NHCirrhosis +14 more
🎬Video coming soon
Abdomen Inspection
Rule in:VHBowel Obstruction, SHAscites, ICCushing Syndrome +3 more
Rule out:SHAscites, SHBowel Obstruction, NHCushing Syndrome +3 more
Abdominojugular RefluxMembers
Sign in
Abdominojugular Reflux
aka Hepatojugular reflux
Rule in:SHElevated Pulmonary Capillary Wedge Pressure, SHHeart Failure, IEConstrictive Pericarditis +1 more
Rule out:ICElevated Pulmonary Capillary Wedge Pressure, NHHeart Failure, IEConstrictive Pericarditis +1 more
🎬Video coming soon
Hand Inspection
Rule in:HHepatopulmonary Syndrome, HHypoxemia, SHCrohn Disease +17 more
Rule out:SHHepatopulmonary Syndrome, SHOsteoarthritis, MHAnemia +17 more

Related Systems / Regions

AbdomenCardiovascularEndocrineGeneral and Vital Signs

Related Diagnoses

Cardiovascular DiseaseMetabolic SyndromeType 2 Diabetes MellitusVisceral Adiposity

Related Chief Complaints

Central Weight GainDaytime SleepinessExertional DyspneaFatigueIncreased Thirst and UrinationJoint PainKnee PainShortness of BreathSnoringWeight Gain

References

Research in progress on one or more findings above; ratings may change.

  • Darbandi M, Pasdar Y, Moradi S, et al. Discriminatory Capacity of Anthropometric Indices for Cardiovascular Disease in Adults: A Systematic Review and Meta-Analysis. Prev Chronic Dis. 2020;17:200112. doi:10.5888/pcd17.200112. PMID: 33092686.
  • Yu J, Tao Y, Tao Y, Yang S, Yu Y, Li B, Jin L. Optimal cut-off of obesity indices to predict cardiovascular disease risk factors and metabolic syndrome among adults in Northeast China. BMC Public Health. 2016;16(1):1079. doi:10.1186/s12889-016-3694-5. PMID: 27737656.
  • Roriz AK, de Oliveira CC, Moreira PA, Eickemberg M, Medeiros JM, Sampaio LR. Methods of predicting visceral fat in Brazilian adults and older adults: a comparison between anthropometry and computerized tomography. Arch Latinoam Nutr. 2011;61(1):5-12. PMID: 22097284.
  • Qiao Q, Nyamdorj R. The optimal cutoff values and their performance of waist circumference and waist-to-hip ratio for diagnosing type II diabetes. Eur J Clin Nutr. 2010;64(1):23-29. doi:10.1038/ejcn.2009.92. PMID: 19690576. Named as closest available evidence only; does not anchor a tier.
  • World Health Organization. Waist Circumference and Waist-Hip Ratio: Report of a WHO Expert Consultation, Geneva, 8-11 December 2008. Geneva: World Health Organization; 2011.

Research last updated September 10, 2026.