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Adiposity refers to the amount of fat tissue in a persons body. A person's fatness or adiposity can be measured using various tools that measure percentage body fat including dual energy x-ray absortimetry (DXA) scan, other commercial impedance based body composition analyzers, or by the new body adiposity index (BAI).

Body adiposity index

The traditional way to measure a person's adiposity using the body mass index or BMI is known to be of some what limited accuracy. An alternative parameter, called the body adiposity index is proposed as a more accurate measure of a persons percentage adiosity.

How is body adiposity index measured

BAI is measure by (hip circumference)/((height)(1.5))-18)). Learn more on body adiposity index

Distribution of the weight

The increased health risks seen with excess adiposity of the body is more importantly associated with the distribution of the body weight as can be measured by a person's waist circumference. Waist circumference is easy to measure using a tape at the most prominent portion of the belly and is an important indicator of cardio-metabolic risk as it is one of the 5 criteria for metabolic syndrome.

Increased central (abdominal) adiposity has a special importance be-cause of increased risk of cardio-metabolic disorders.2 Waist circumference (WC) is the best simple index of fat distribution, since it is least affected by gender, race, and overall adiposity.

Metabolically obese normal weight individuals

Also called Thin Outside, Fat Inside(TOFI), metabolically obese normal weight individuals are common in the society and pose challenges for health care professionals that simply look at the body mass index alone as a measure of body fatness. The metabolically obese normal weight or TOFI individuals have disproportionate amount of fat (adipose tissue) stored within their abdomen.

Measuring the body fat percentage

One of the best ways to measure percentage body adiposity is by using magnetic resonance Imaging (MRI) or CT scanning. Indirect methods such as waist circumference are not as useful in TOFI people as individuals with an identical waist circumference can have vastly different levels of internal fat.

Incidence of TOFI

It was estimated that up to 14% of the men and 12% of the women scanned with a BMI 20–25 kg/m2 were classified as TOFI.

Metabolically Normal but Obese Individuals

There are some individuals that are obese with excess overall body adiposity, but their distribution of fat is such that they do not have increased visceral fat or belly fat but have more brown adipose tissue that does not increase their risk of cardio-metabolic problems.

Apple versus Pear shape of the body

The health risks associated with obesity are also related to the body shape (i.e., regional fat distribution).


Although this research is still evolving, the current thinking is that the apple shaped body with excess weight in the belly or intra-adbominal areas with excess visceral fat poses significantly higher health risk (apple shaped body) compared to those that have more weight in the lower part of the body, especially in the hips. However, there is recent research to suggest that you do not want too much weight in the hip region either.

Waist circumference

The [[waist circumference serves as a simple and easy measure of cardiometabolic risk. The waist should be measured half way between hips and abdomen, usually at the belly button level for most people.

Ideal waist circumference for women is less than 80cm (32"). A waist circumference of 80cm to 88cm (32" to 35") is considered high and those that have a waist of more than 88cm (35") are considered to he at very high risk of cardiometabolic problems.

For men, the ideal waist circumference is less than 94cm (37") and a waist circumference of 94cm to 102cm (37" to 40") is considered high, and a waist of more than 102cm (40") is considered very high.

Waist to hip ratio

A ratio of 1.0 or more in men or 0.85 or more in women indicates that you are carrying too much weight around your middle. This puts you at increased risk of diseases that are linked to obesity, such as type 2 diabetes and heart disease.


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