Impact of using waist-to-height ratio for diagnosing obesity in general digestive outpatient consultations

INTRODUCTION: Body mass index (BMI) is widely used to diagnose obesity, but it has limitations in assessing abdominal adiposity. Recently, it has been proposed to complement it with the waist-to-height ratio (WtHR) for the diagnosis of obesity. This study evaluates the impact of using WtHR in the diagnosis of obesity in patients seen in gastroenterology outpatient consultations. METHODS: Observational study in a tertiary hospital between December 2023 and April 2025. A total of 253 patients referred from primary care were included. Clinical and anthropometric variables and comorbidities were collected. Obesity was defined as a BMI ≥ 30 kg/m² and a WtHR ≥ 0.5 in patients with a BMI between 25-30 kg/m² and associated comorbidities. Changes in the diagnosis of obesity using WtHR, the presence of metabolic syndrome, and the prevalence of obesity according to the reason for consultation were studied. RESULTS: 21.7% (55/253) of patients were obese according to BMI, while 54.9% (139/253) were diagnosed as obese when the WtHR criterion was included. In men, the change in the diagnosis of obesity went from 22.6% (26/115) to 67% (77/115). A prevalence of metabolic syndrome of 17.4% (44/253) was observed. Dyspepsia was the main reason for consultation, with obesity present in 18% (11/61); when applying the criterion that includes WtHR, 47.5% (29/61) were obese. CONCLUSIONS: The use of WtHR in gastroenterology consultations allows for better identification of abdominal obesity, especially in patients with digestive and metabolic comorbidities. Its systematic incorporation alongside BMI can improve the clinical and therapeutic approach to these patients.