What is the medical term for a condition with a normal Body Mass Index (BMI) but a large waist measurement and high-risk waist-hip ratio level?

Medical Terminology for Normal BMI with Central Adiposity

The condition you're describing is termed "central obesity" or "abdominal obesity," and when present with normal BMI, it represents a phenotype sometimes referred to as "normal-weight central obesity" or "metabolically obese normal weight" (MONW). 1

Key Diagnostic Terms

Central obesity or abdominal obesity is the primary medical term used when waist circumference and waist-hip ratio are elevated despite normal BMI. 1 This pattern was historically described by Jean Vague as "android obesity" - the high-risk form of fat distribution more commonly found in men, as opposed to "gynoid" obesity (lower-body fat distribution). 1

Clinical Significance and Risk Assessment

This body composition pattern is clinically important because:

• Central adiposity captured by waist circumference has been associated with atherosclerotic cardiovascular disease (ASCVD) risk and may be missed when BMI is used as the only measure of obesity. 1, 2

• The distribution of body fat is more closely related to complications such as insulin resistance, atherogenic dyslipidemia, type 2 diabetes, and cardiovascular disease than the absolute degree of fatness itself. 1

• Individuals with excess visceral adipose tissue (VAT) are characterized by a more diabetogenic/atherogenic risk factor profile, even when matched for subcutaneous fat levels. 1

Diagnostic Thresholds

High-risk waist-hip ratio is defined as:

• ≥0.95 in men 3
• ≥0.80 in women 3

Elevated waist circumference indicating central obesity:

• ≥102 cm (40 inches) in men 1, 2
• ≥88 cm (35 inches) in women 1, 2

For Asian populations, lower thresholds apply:

• ≥90 cm in men and ≥80 cm in women 3, 2

Clinical Implications

Combining waist circumference and BMI provides the best approach for assessing obesity-related risk. 1, 2 This is particularly important because:

• Waist and hip circumferences measure different aspects of body composition and have independent and often opposite effects on cardiovascular disease risk factors. 4

• A large waist circumference (adjusted for BMI and hip circumference) is associated with low HDL-cholesterol, high fasting triglycerides, insulin, and glucose concentrations. 4

• For every 0.01 increase in waist-hip ratio, cardiovascular disease risk increases by approximately 5%. 3

Common Clinical Pitfall

BMI cannot always properly discriminate the risk of chronic disease at the individual level - some individuals with normal BMI may have numerous metabolic abnormalities including insulin resistance, glucose intolerance, dyslipidemia, and hypertension due to central fat distribution. 1 This is why waist circumference measurement is recommended in all patients with BMI <35 kg/m² to capture central adiposity that BMI alone may miss. 1, 2