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NHS / NICE scale · waist as the determinant

Central Adiposity Screener

BMI proposes a rating. Waist circumference then decides whether that rating holds — confirming it, raising it, or failing to back it up. BMI is highly specific but misses roughly half of people carrying excess fat, so a normal BMI with a big waist is under-rated, and a high BMI with a slim waist may be over-rated. The waist is the tie-breaker.

Your measurements

Units
Sex
cm
kg
cm

At the navel, tape flat, breathe out.

Risk readout

Overall weight-related risk

Increased

Partly confirmed — waist-to-height raised
LowIncreasedHighVery high

BMI alone marker sits under the needle — no shift.

BMI

26.5

Overweight

NHS cut-offs

Waist · determinant

92.0 cm

Below action level 1

AL1 94 · AL2 102 cm

Waist ÷ height

0.517

0.50–0.59

Corroborator · keep under 0.50

Body Roundness

3.68

Below average

Context · lowest risk 4.5–5.5

Interpretation

Your waist sits below the action level, yet waist-to-height is 0.517 — at or above 0.50. That keeps the BMI rating of Increased standing rather than downgrading it. Waist-to-height often flags central adiposity a single waist threshold misses, especially in shorter people.

How the waist adjudicates

BMI sets the proposed rating. If the waist reaches an action level it corroborates or raises that rating. If the waist sits below action level 1 — and waist-to-height is also under 0.50 — the BMI rating is marked not confirmed and pulled down toward what the waist supports, since BMI can't tell fat from muscle. At Obesity II+ the waist adds little, so the rating stays very high on BMI alone.

Sources: NICE NG246 and NHS BMI / waist-to-height guidance; waist action levels and the specificity-vs-sensitivity framing from Barbell Medicine's Body Roundness Index article; BRI mortality bands from Zhang et al., JAMA Network Open 2024.

A screening aid, not a diagnosis. Imperfect for very muscular or very short people, older adults, and during pregnancy. Discuss results with a clinician.

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