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How to measure your waist and what the number means

A tape measure tells you something your bathroom scale cannot: where your fat is. During menopause that matters more than the total.

Reviewed by Claudia Muresian, health psychologist, fitness coach and healthy nutrition specialist Researched and drafted by the Fit Over 40 editorial team. Last updated November 11, 2026. 5 minute read. How we research and review

The short version

  • Measure around your bare middle, just above the hip bones, right after breathing out.
  • For women, health risk rises when the waist is over 35 inches (88 cm).
  • A waist of more than half your height is another warning sign.
  • A large waist raises risk even when your weight is in the normal range.
  • Re-measure every two to four weeks. It is the best progress marker during the menopause years.

How to measure

  1. Stand up straight in front of a mirror with your middle bare.
  2. Find the top of your hip bones with your fingers.
  3. Wrap a flexible tape measure around your middle just above the hip bones. Keep it level all the way round and snug, without pressing into the skin.
  4. Breathe in, breathe out normally, and read the number right after you breathe out.1
  5. Write it down with the date.

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What the number means

MeasureHigher-risk range for women
Waist circumferenceOver 35 inches (88 cm)
Waist-to-height ratioOver 0.5, meaning your waist is more than half your height
Waist-to-hip ratioOver 0.85

Sources: The Menopause Society, citing National Heart, Lung, and Blood Institute guidelines, and WebMD's summary of international definitions.2,4

These are screening figures. They flag a reason to talk to your doctor. They are not a diagnosis.

Why waist beats weight in menopause

During the menopause transition, women gain fat and lose lean mass at the same time, so the scale can stay almost level while the body changes underneath.6 Falling estrogen also shifts fat storage toward the abdomen, including the visceral fat that surrounds the organs.5 A tape measure catches both changes. A scale catches neither.

What a larger waist is linked to

If most of your fat sits around your waist instead of your hips, your risk of heart disease and type 2 diabetes is higher.1

A study by Harvard and US National Institutes of Health researchers followed women for many years. Those with a waist of 35 inches or more were about twice as likely to die of heart disease as women with a waist under 28 inches, whatever their body mass index. The pattern for cancer deaths was similar.3

What to do with your number

  • Under 35 inches and steady: keep doing what you are doing and re-measure monthly.
  • Creeping up: act now. It is easier to stop a rise than to reverse one. Start with what actually reduces menopause belly fat.
  • Over 35 inches: book a check-up. Your doctor will look at blood pressure, blood sugar and cholesterol as well.1

Exercise works on the waist directly. Across 101 trials, training reduced waist circumference and visceral fat in postmenopausal women.7 See cardio or weights: which is better?

Common questions

My weight is normal but my waist is over 35 inches. Does it matter?

Yes. An increased waist can signal higher risk even at a normal weight. In one large study, normal-weight women with larger waists still had higher death rates from heart disease than women with smaller waists. Mention it to your doctor.3

Is the threshold the same for every woman?

The 35-inch figure is a general screening threshold. Some organizations use lower cut-offs, such as 31.5 inches, and slightly different figures for some Asian populations. Your doctor can interpret your number in context.4

Can I shrink my waist with ab exercises?

Ab exercises strengthen the muscles but do not remove the fat over them. Waist size comes down with overall fat loss from activity and eating changes.4,7

References

  1. National Heart, Lung, and Blood Institute. Assessing your weight and health risk. https://www.nhlbi.nih.gov/health/educational/lose_wt/risk
  2. The Menopause Society. Are you officially overweight? https://menopause.org/for-women/menopauseflashes/exercise-and-diet/are-you-officially-overweight-
  3. Eunice Kennedy Shriver National Institute of Child Health and Human Development. Excess fat around the waist may increase death risk for women. April 7, 2008. https://www.nichd.nih.gov/newsroom/releases/april07_2008
  4. WebMD. How to measure waist circumference. https://www.webmd.com/diet/waist-measurement
  5. Cleveland Clinic. What causes 'menopause belly' and what you can do about it. https://health.clevelandclinic.org/menopause-belly
  6. Greendale GA, Sternfeld B, Huang M, et al. Changes in body composition and weight during the menopause transition. JCI Insight. 2019;4(5):e124865. https://doi.org/10.1172/jci.insight.124865
  7. Khalafi M, Habibi Maleki A, Sakhaei MH, et al. The effects of exercise training on body composition in postmenopausal women: a systematic review and meta-analysis. Front Endocrinol. 2023;14:1183765. https://pubmed.ncbi.nlm.nih.gov/37388207/
About this article

Every health claim above links to its source. Before publication the article was read and approved by Claudia Muresian, health psychologist, fitness coach and healthy nutrition specialist. It is general information and cannot take your personal history into account, so use it to prepare for a conversation with your own clinician.

Spotted an error? Tell us and we will check it.

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