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Appendix 3: BMI and Waist Circumference Charts 245
D.O.B. [DDMMYY] //
Because a high BMI by itself may not be a guarantor of obesity/overweight, a high waist centile added to a high
BMI centile will confirm fatness more conclusively. The shaded area represents a healthy waist range.
Measuring the Waist
The waist is defined as the mid-way point between the lowest rib cage and the iliac crest and should be
Tape measured, preferably, with a special tension tape [see illustrations below].
When measuring her waist, the girl should ideally be wearing only underclothes. Ask her to stand with her feet
together and weight evenly distributed with her arms relaxed. Ask her to breathe normally and take the waist
measurement at the end of a normal expiration.
The waist can also be identified by asking her to bend to one side. Measurement is taken at the point of flexure.
If she is wearing a shirt or vest, deduct 1cm before recording and plotting the waist measurement.
There is no consensus about how to define paediatric obesity using waist measurement. For clinical use the
99.6th or 98th centiles are suggested cut-offs for obesity and the 91st centile for overweight, like the BMI [see
chart overleaf].
108 108
106 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 106
104 years 104
102 102
100 100
98 98
96 96
94 94
92 92
90 90
88 88
86 86
84 99.6th 84
82 82
80 80
78 98th 78
76 76
74 74
91st
72 72
70 70cm cm
75th
68 68
66 50th 66
64 64
62 25th 62
60 9th 60
58 2nd 58
56 56
0.4th
54 54
52 52
50 50
48 48
46 46
44 44
42 42
40 40
Data: 1977
38 years 38
36 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 36
34 Reference 34
The development of waist circumference percentiles in British children aged 5-16.9 yrs: (McCarthy HD et al) European Journal of Clinical Nutrition (2001): 55: 902-907.
