Practical tools for evaluating body fat distribution: Applications in clinical and home-based weight management

Obesity, clinically defined as an excess of adipose tissue, remains a growing public health concern because of its strong association with cardiometabolic comorbidities and the impact on the quality of life of those affected by this disease. Although body mass index (BMI) is widely used for diagnosing and stratifying obesity, it has limitations, including its inability to capture body fat distribution or differentiate between visceral and subcutaneous fat, key determinants in metabolic disease. This article reviews the incorporation of anthropometric and body composition assessment tools, including waist circumference (WC), waist to hip ratio, waist to height ratio, body roundness index, conicity index, sagittal abdominal diameter, a body shape index, and skinfold measurements in obesity diagnosis and their potential to offer greater insight into obesity-related health risks than BMI alone. Additionally, we explore home-based assessment tools-including digital scales, at-home WC measurements, bioelectrical impedance analysis, body scanning apps, and commercial dual-energy x-ray absorptiometry (DEXA)-in supporting remote weight management in telehealth settings. Although these tools show promise, they vary in accuracy, accessibility, and usability. Integrating both clinic-based and home-based assessments into routine obesity care may improve risk stratification and support individualized interventions.