Standard BMI measurements don't accurately show how much body fat people with spinal cord injuries have, often making them seem less obese than they really are.

BMI, waist size, and waist-to-height ratio all relate to how much fat is stored around the belly in people with spinal cord injuries.

For men with spinal cord injuries, using a waist size of 86.5 cm instead of 102 cm identifies more people as obese (36% vs 3%), which is a big difference.

Using a waist size of 86.5 cm instead of 102 cm in men with spinal cord injuries better identifies who has obesity based on body fat percentage, catching more true cases (68.8% vs 6.3%) while still correctly identifying most non-obese people (90% vs 100%).

Waist size and waist-to-height ratio are linked to five key heart disease risk factors and overall heart disease risk in people with spinal cord injuries.

In men with spinal cord injuries, waist size strongly correlates with total body fat and belly fat, indicating it's a good measure of overall fatness.