How to Test Your Waist-to-Height Ratio

Gary Brecka (0:00)

There's a new term taking over the internet, and it's called skinny fat. In research, this has a name, normal weight obesity, a BMI that would still sail through any physical, sitting on top of a body fat percentage that wouldn't. And here's the number I want you to hear. 26% of the men and 38% of the women had excess body fat. More than a third of women who have never once been told they had a weight problem. The thresholds are above 25% body fat in men and above 35% in women. Which brings me to the part nobody wants to hear. You can not detect this yourself, not with the two instruments you're using right now. The scale can't see it, it has one number, and the number can't tell you what the pounds are made of. Two people, same height, same weight, same age. One is fine, one is in trouble, and the scale reports them as identical. Skinny fat is not a body you're stuck with, it's a measurement you have never taken. So here's what I want you to track instead. Four things, three of them are nearly free.

I read a thread this week where a kid asked a simple question, should I eat more or should I eat less? Three people answered him. The first one said bulk, the second one said cut. The third one told him if he cuts, he'll turn into a 50-pound skeleton. So now he's afraid to eat, and he's afraid not to eat, and he doesn't either. I'm biohacker and human biologist Gary Brecka, and you're listening to the Ultimate Human Podcast where we dig into the real science behind longevity and disease prevention. There's a new term taking over the internet, built around the body they're running from, and it's called skinny fat. So here's why I'm doing this episode. That world is wrong about almost every fix, but they're not wrong about something that's there. They found something real, and then buried it under the worst advice on the internet. In research, this has a name, normal weight obesity, a BMI that would still sail through any physical, sitting on top of a body fat percentage that wouldn't. And here's the number I want you to hear, because this is not a niche problem for teenagers on a forum. A 2023 analysis in Frontiers of Nutrition took adults with completely normal BMI and actually scanned them. They did not use a bathroom scale. 26% of the men and 38% of the women had excess body fat. More than a third of women who have never once been told they had a weight problem.

The thresholds are above 25% body fat in men and above 35% in women. And I'll be honest, the published cutoffs vary quite a bit, because this is a young field, but the direction is not in dispute. Which brings me to the part nobody wants to hear. You cannot detect this yourself, not with the two instruments you're using right now. The scale can't see it, it has one number, and the number can't tell you what the pounds are made of. Two people, same height, same weight, same age. One is fine, one is in trouble, and the scale reports them as identical. And the mirror is even worse, because your eyes are not a reliable testing instrument. So here's what I want you to track instead. Four things, three of them are nearly free. Waist to height. Measure your waist, divide it by your height, and you want it under 0.5.

Nice. The UK clinical body put 0.6 and above at your high risk. So keep your waist under half your height. That's the test, and you can run it right now with a tape measure. Grip strength, a dynanometer. It costs 30 bucks, and 16 in women flags probable sarcopenia under the European consensus criteria. This one matters most, because it's the only measurement here that tells you whether you're losing function, and the function is the whole point. Next, triglyceride to HDL. This is already sitting on a blood panel you've had. Divide your triglycerides by your HDL, and you want that under 3, under 2 if you're black. If we use this ratio instead of fasting insulin for a simple reason, insulin assays are not standardized between labs. The ratio is. Then there's something that does cost a little bit. It's a DEXA scan. Scan once so you know exactly where you stand. Then follow up every 6 months. Not for the weight, but for the split.

Four numbers. That's the whole dashboard, and not one of them is a photograph. And if this part interests you, go watch the episode I filmed with Dr. Josh Axe on why your normal blood work is lying to you, and what to test for instead. Same problem as this one. One layer deeper. I highly recommend it. Now, back to the kid from the beginning of the episode asking if he should eat more or eat less. The actual answer has little to do with how much he's eating. Because the question is wrong. He's asking about weight, and his problem is body composition. You can't solve a composition problem by moving weight in either direction. He needs to change what his body is made of while the scale barely moves at all. So three things will actually get the job done here. Number one, protein. Your goal is 0.7 to 1 gram per pound of body weight daily. Spread across your meals. Not all at dinner.