Why would a dangerously underweight woman have a relatively high waist-hip ratio?

Question

I'm 83 pounds at 5'0, which is a BMI of 16.2, which is on the verge of the "starvation" category according to the World Health Organization.
But as per my calculations, my waist-hip ratio (WHR) is.83. Apparently that's the average WHR for a woman, but apparently that's classified as "overweight" or even "obese".

The average woman is overweight so that makes sense for the average woman, but literally nobody can tell me that 83 pounds is overweight & that I need to lose weight to be healthy.
But apparently a large part of the connection between WHR & poor health is due to heart disease. Heart disease runs in my family VERY, VERY badly. Could that be the reason my WHR is relatively high? But I'm also sedentary, so maybe that's a factor?
If you're not fairly certain that you know the answer, please choose the first option. I want input mainly from people who know what they're talking about.

Warmapplecrumble · Accepted Answer

I tried to research this a lot.

First to understand it I checked myself and I have : waist-hip ratio of 0.78 and BMI of 20.9.

Then I further searched the question and came to this website.

drhoffman.com/.../

"Q: My BMI is 19.8 but my waist-to-hip ratio is.96. My body fat percentage as measured in a health club ranges from 38 to 40 percent! My doctor said it’s hereditary—both my mother and grandmother carried weight around the midsection.

My HgbA1c is 5.6 to 5.8. I exercise every day which includes biking, hiking, strength training and skiing. Am I in big trouble?

A: The waist-to-hip ratio (WHR) is an indicator of health status and determines the presence of abdominal obesity—a risk factor for chronic disease such as diabetes and cardiovascular disease. Abdominal obesity is defined as a WHR above 1.0 (for men) and 0.8 (for women) by the National Institute of Diabetes, Digestive and Kidney Disorders (NIDDK). You can find the app for WHR here.

While your WHR is in the higher risk range, what’s more telling is your body fat percentage (greater than 30% is defined as metabolic obesity) and your HgbA1c which puts you in the range of prediabetes.

Here’s the conundrum: Your body mass index (BMI) indicates you are well within the normal weight category (normal is between 18.5 and 24.9). And this is why I’m not fond of the BMI as a health determinant: You’re the perfect example of someone who is “normal” weight, but metabolically obese. It’s simply a poor indicator of weight and health status.

Another example: I have patients who develop high blood pressure with BMIs approaching 23 or 23.5, even though this is considered normal weight. These individuals also tend to carry more body fat.

On the other end of the spectrum, my athletic patients will have a much higher BMI—often over 25 (considered the overweight category), but it’s mostly lean body mass with very little body fat—clearly NOT overweight!

What is most important is the presence of metabolic obesity (body fat percentage as determined by body composition) and abdominal obesity as determined by WHR, not BMI.

So, you’re only in trouble if you don’t make any changes. Daily exercise is key and you’re already doing that. The big change for you will be your diet. Prediabetes is defined as a condition of carbohydrate intolerance. Lower your carbs and you should start to see a change in your WHR and body composition over time.

After four to six months, recheck your HgbA1c. An optimal number would be 5.0.

To your health!"

However, I personally think that because there is very little weight around the hip area this brings your WHR to a higher level than usual. So I think it must be a error in the calculation process and it does not take into consideration of underweight users.
I really think this is something a doctor can actually answer far better and would recommend that you ask your concerns to the doctor.

Also being underweight can increase heart problems.
"Underweight: another risk factor for cardiovascular disease?"
www.ncbi.nlm.nih.gov/pmc/articles/PMC5728753/

sejla · Accepted Answer

Those BMIs are kind of whack sometimes. I got up to 130 at 5' 1 1/2" sliding into menopause. While that is overweight according to BMI i was obese. Women my age have more weight in the mid section because when our ovaries shut down the only place that produces estrogen is in the fat cells.

Right now at 118 I'm carrying stomach weight because I don't move much due to chronic fatigue. I'm sure if I went according to the BMI based on my stomach I'd be close to the high BMI

You need to gain a bit of weight but increasing your calorie intake I got down to 89 pounds one time and it was not good. My normal weight when I was young was 95 pounds.

Kurαȷ · Accepted Answer

Firstly, you are a short woman, the demographic for which the BMI is the most unreliable indicator.
The more your height deviates from the standard, the more your BMI has to be adjusted for it.
You may have to add up to 2 points to your BMI, so if you aren't doing it already, my guess would be that your "actual" BMI is closer to 18 rather than 16.

Secondly, the waist-to-hip ratio is usually a more reliable indicator for health than BMI, because it is less influenced by variations in lean mass (limb size, bone and skeletal muscle proportion to overall body weight).

It could be that your frame is simply too small and that your proportion of fat to lean mass is just higher than it is for other people.
This is the case with Asians, who pretty much have to adjust their BMI by +2 due to their frames and lean mass proportions (in other words, they start being overweight at over 23 BMI, rather than 25).

That being said, you should always be able to assess your body fat visually and by touch.
Is there stuff to pinch on your stomach? Etc.

Anonymous · Accepted Answer

These numbers are just a rule of thumb, a guideline. In order to make any sense of them you must consider all of the variables.

If you look up WHR and read something like the wikipedia page like i just did:

en.wikipedia.org/wiki/Waist%E2%80%93hip_ratio

You will see that it is talking about ratios over 0.8 for women being bad because of the fat distribution.

But you dont have a fat distribtion, you only weigh 83 pounds.

According to your BMI you are dangerously underweight and as such you should consult a professional person, goto your doctor.

Massageman · Answer

The "gold standard" of measuring the BMI is "water displacement" testing, not using only body measurements. Bone and muscle tissue are substantially more dense than adipose (fatty) tissue, and can skew BMIs when only measurements and "the ratio" are used. "Water displacement" is cumbersome, at best, since you literally have to be dunked in a tank of water, but it IS the best way for an accurate BMI.

MrOracle · Answer

Your HWR is higher not because you are bigger in the waist than you should be, but because you are smaller in the hips than you should be. If you were to gain weight, chances are it would go to your hips/butt and maybe to your boobs, but probably not to your waist much (though if you aren't getting exercise, it might).

Anyway, being so underweight, you can't expect to land in the "theoretical ideal" of something like a HWR. Improving your diet and getting more exercise will solve the HWR as a side benefit, but that's the least important factor - your overall health is what's important.

Anonymous · Answer

You should post a photo.
What matters most more than weight because fat is way lighter than muscle is to measure your height and devise that in half. That half should be the size of your waist at the biggest! Which means you should not go over that half number, in fact you should aim to have much smaller than that half because the half is the limit that should not be surpassed.

If it’s bigger than that, you’re prone to heart problems and a number of other diseases. Regardless of how much you weight. Your waist should not be bigger than half your size in height.

And yes! Even if you’re underweight one could still say you need to eat healthier to gain weight in the right places and lose fat from the right places. Also no cardio will kill your heart super fast. Go get active!! Lose fat and gain muscle and mass in the right places

SpearsAndStones · Answer

It's probably due to your bone structure. You probably have almost no body fat, so your skeletal frame is responsible for most of your figure. You just have a wider pelvis for your weight.

If you're asking this because you have a health concern, talk to a doctor, but I think, you're probably fine. I couldn't see how it relates to high blood pressure, and with how thin you are, I doubt it has to do with being sedentary either. If you're asking this because you have a cosmetic concern, a high WHR is actually considered subconsciously more attractive than any other physical trait in women. So don't worry about that either.

Anonymous · Answer

I never use the weight ratio charts. They aren't accurate.

When my father was dying from cancer, he became very underweight. In fact, he was so thin, he looked like a victim of Bergen-Belsen , but yet, the nurse at his own Doctors surgery said he needed to lose weight... she was going by the weight ratio chart.

But when my father told his consultant - one of the surgeons who had previously operated on him at the hospital - he was so furious. He wrote a letter of complaint to my father's Doctor about the nurse. He needed to gain weight, not lose it

Purple_Summer · Answer

OMFG girl you cannot allow yourself to be obsessed with those kind of stupid ratios. Take care of your health first, you already posted that you are too skinny but refuse to put on weight. Waist to hip ratio? Everyone has a different bone structure, that does not determine health in any way. And people who have more body fat on them, the places that they gain the fat in are different in everyone, so that makes the proportions even more varied.

Lliam · Answer

I didn't understand your question. Your initially asked, "Why would a dangerously underweight woman have a relatively high waist-hip ratio?" To that I would have simply said it's because of her hip bones.
But then you went into WHO stats, genetics and lifestyle regarding heart disease.

Noobweps · Answer

If you have an eating disorder, please get help. I imagine it's the fat distribution. Obese women start storing fat in their waists after a while. I imagine on the flip side, severely underweight women have the same fat distribution. Only that there's no fat to distribute.

nerms123 · Answer

It’s because you don’t have that much fat on your hips so it’s making the ratio higher. If you weighed more then your hips would be wider compared to your waist. Hope that helps.

Grond21 · Answer

Waist to hip ratio isn't dictated just by fat. It's also dictated by bone structure. If your hips are relatively narrow, as well as your torso, then your waist to hip ratio will be high no matter your fat level.

Walrus_au · Answer

talk to a doctor.

BMI is a questionable way of measuring health at the best of times. As a tool it was designed to give a picture of a population situation, not individuals. And even in that it was not very good.

Considering how very different people can be, the best option would be to talk to your doctor who can look at all the factors and give you a far more nuanced and personalised answer.

JSmuve · Answer

Well, I'll ignore that chart because I question the reliability of it.
A high waist:hip ratio means you either have narrow hips or you're carrying too much weight through the mid-section. Based on your weight, I imagine you fall under the narrow hips category.

Felinegirl · Answer

Your hips get smaller, your waist does not due to organs being there.

If you want to have a better ratio, gain some weight! You'll stop looking like a stick (which is probably the body type you have right now with those numbers).

bolverk · Answer

Ignore the charts as they are a base generalisation, If you're that concerned have your doctor do a full check up, they will give you a better idea if you're truthful over your background. You may be worrying yourself over nothing if you are not affected by heart disease, just because it runs in your family does not mean you'll end up suffering from it, gst check by your doctor and save yourself the grief.

Ellie-V · Answer

BMI isn’t that reliable when it comes to to determining who is unhealthy and who is not on a broad scale.

Izumiblu · Answer

If you are concerned about whr being an indicator for respiratory health then don’t be.

I like you have a low BMI and whr similar to yours. Has more to do with bone structure and muscle placement for the whr.

Don’t worry about it.

1truekhaleesi · Answer

I'm 99.9% sure this has nothing to do with heart disease. You probably have wide hips thanks to genetics. Although, if you weigh too little that can cause your heart to work extra hard to keep you alive.

SongBird3 · Answer

Sweetheart BMI is not an accurate indicator for health. Any Dr. will tell you that.  It doesn’t account for muscle, bone structure, etc.

Smiley_face101 · Answer

It could be your bone stracture as in you dont have an hourglass figure and you are unhealthy. When it comes to health being underweight is worse then being obese.

theharlequin · Answer

I don't know how they can classify women's weight based upon WHR. That's absurd. The simple answer to this is you have narrow hips, which is a skeletal thing, not a weight thing.

Why would a dangerously underweight woman have a relatively high waist-hip ratio?

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