Body Mass Index and Waist Circumference as Indicators of Obesity among Indian Students: A Cross-Sectional Study

Purpose: Obesity is a growing public health problem among Indian young adults, and body mass index (BMI) alone may under-detect central adiposity in South Asians. This study estimated the prevalence of overweight, obesity and central obesity among Indian medical students (aged 17– 27 years) studying in Kyrgyzstan, using WHO Asia-Pacific BMI cut-offs and South Asian-specific waist circumference (WC) thresholds, compared men and women, and assessed agreement between BMI-defined and WC-defined risk. Methods: A single-centre cross-sectional study was conducted from February to May 2026 among 317 Indian students (197 men, 120 women) at Asian International University named after S. Tentishev, Kyrgyzstan. BMI was classified by WHO Asia-Pacific cut-offs. Central obesity was defined as WC ≥90 cm in men and ≥80 cm in women (primary analysis). Sensitivity analyses used the WHO/IDF 94/80 cm and 102/88 cm thresholds and waist-to-height ratio (WHtR) ≥0.5. Sexes were compared with Welch’s t-test, the chi-square test and the two-proportion z-test; agreement was assessed with Cohen’s kappa. Prevalences are given with 95% confidence intervals (CI). Main results: Mean BMI was 22.49 ± 3.84 kg/m². 14.2% of students were underweight and 40.7% (95% CI 35.4–46.2) were overweight or obese; mean BMI did not differ between men (22.73 ± 3.83) and women (22.09 ± 3.83) (p = 0.153). Central obesity by the primary definition was present in 19.2% (95% CI 15.3–23.9): 15.2% of men and 25.8% of women (p = 0.020). By WHtR ≥0.5 the prevalence did not differ between men (35.5%) and women (30.0%) (p = 0.311), and mean WHtR was identical (0.474) in both sexes. Agreement between BMI-defined overweight/obesity and central obesity was fair (kappa = 0.39; 95% CI 0.28–0.50). 16.4% of students had both conditions, and 9 students (2.8%; all women) had BMI <23.0 kg/m² with central obesity. Conclusion and practical significance: About two in five Indian medical students in this sample were overweight or obese, and about one in five had central obesity. BMI alone did not identify the 9 students with a normal or low BMI and elevated WC, and WHtR identified 19 students with BMI <23.0 kg/m² and WHtR ≥0.5. The higher proportion of women above the WC threshold was not confirmed by WHtR and partly reflects the lower female threshold. Waist circumference, and where possible WHtR, should be measured together with BMI in institutional health screening of international students.

Keywords: BMI, waist circumference, waist-to-height ratio, obesity, central obesity, Indian students, anthropometric screening.