Trends in Mean Waist Circumference and Abdominal Obesity Among US Adults, 1999-2012

Study Questions:

Has mean waist circumference and abdominal obesity changed over time?


Data from seven cycles of the National Health and Nutrition Examination Survey (NHANES) were used for the present analysis. NHANES is a national sample of the US population. Waist circumference was measured and abdominal obesity was defined as a circumference >102 cm for men and 88 cm for women. Age-adjusted results were reported for each 2-year cycle, starting in 1999-2000 and finishing in 2011-2012. Only those over the age of 20 and nonpregnant women were included.


A total of 32,816 adults, ages 20 years or older, were included in this analysis. The age-adjusted mean waist circumference increased over time from 95.5 cm (95% confidence interval [CI], 94.2-96.8 cm) in 1999-2000 to 98.5 cm (95% CI, 97.5-99.4 cm) in 2011-2012. Significant increases occurred in men, women, non-Hispanic whites, non-Hispanic blacks, and Mexican Americans. Large increases were noted among non-Hispanic white women ages 40-49 years, non-Hispanic black men ages 30-39 years, Mexican American men ages 20-29, Mexican American women ages 70 years or older, and non-Hispanic black women ages 30-39 years. During the years when obesity rates had plateaued (2003 to 2012), mean waist circumference continued to increase among all adults, women, non-Hispanic blacks, and Mexican Americans. The overall age-adjusted prevalence of abdominal obesity increased significantly from 46.4% (95% CI, 42.1%-50.8%) in 1999-2000 to 54.2% (95% CI, 51.3%-57.0%) in 2011- 2012.


The investigators concluded that as the prevalence of obesity may have reached a plateau, the waistlines of US adults continue to expand. These results support the routine measurement of waist circumference in clinical care consistent with current recommendations as a key step in initiating the prevention, control, and management of obesity among patients.


These data are concerning, given the association between abdominal obesity and type 2 diabetes and vascular disease. As the authors recommend, clinicians are recommended to measure waist circumference at clinical visits and discuss methods for reducing abdominal girth when increased. Public health interventions that prevent increases in waist circumference are also warranted.

Clinical Topics: Diabetes and Cardiometabolic Disease

Keywords: Obesity, Abdominal, Waist Circumference, Body Mass Index, Vascular Diseases, Diabetes Mellitus, Type 2, Confidence Intervals, Nutrition Surveys

< Back to Listings