Neck Circumference as A Screening Tool to Predict Obesity: A Cross Sectional Study in Coastal Karnataka, India


  • Shyamsundar Shreedhar Karwar Institute of Medical Sciences, Karwar, Karnataka, India
  • Prashant M Naik Karwar Institute of Medical Sciences, Karwar, Karnataka, India
  • Geeta Karwar Institute of Medical Sciences, Karwar, Karnataka, India
  • Naveenkumar Havale Karwar Institute of Medical Sciences, Karwar, Karnataka, India
  • Manjula MN Karwar Institute of Medical Sciences, Karwar, Karnataka, India



Neck circumference, BMI, obesity, ROC


Background: Obesity is a disease of public health importance impacting most body systems. It leads to a range of NCD’s. BMI is commonly used to classify overweight and obesity in adults. Others measurements such as WC and WHR are considered as acceptable measures of obesity.  However in community settings these can be a time consuming method. Instead Neck circumference (NC) can be used to screen for obesity.

Methodology: A cross sectional study conducted among 310 study participants in rural field practice area of Government medical college, Karwar. Socio demographic characteristics were collected using pre designed semi structured questionnaire and anthropometric measurements as per standard guidelines. Data analyzed using Epi-info 7.2 version. Statistical tests like Pearson’s correlation coefficient were used to assess correlation. NC cut off values were obtained from ROC.

Results: In our study, the correlation of NC with BMI was highly correlated among both males(r=0.529), and females (r=0.565). Kappa statistics depicted moderate agreement with BMI [males (κ = 0.512) ; females (κ = 0.496) and NC in the study population. The cut-off values obtained for neck circumference using ROC curve for males (35.5cm) and females (31.5cm) were statically significant associated in comparison to BMI to determine obesity in both males (χ2 = 58.57,  and females (χ2 = 21.54).

Conclusion: This study concluded that men with NC ≥ 35.5 cms and females with NC ≥ 31.5 cms are to be considered obese. The sensitivity  of  this screening  test  for  these  cut-off’s  was  79.83%  and  82.4%  in  males  and  females  respectively.


World Health Organization;World Obesity Day 2022 - Accelerating action to stop obesity Available at: Assessed on 15/03/2022, 12.00pm.

Government of India. Ministry of Health and Family Welfare. National Family Health Survey-5 data. Available at: Assessed on 15/03/2022, 12.30pm.

J Alastair Innes, Anna R Dover, Karen Fairhurst. Macleod's Clinical Examination, 14th edition. London : Elsevier ; 2018. P 189-90, 194-195.

(WHO TR 854) Report of a WHO Expert Committee. Physical status: The use and interpretation of anthropometry WHO Technical Report Series 854.1995.

World Health Organization. Waist circumference and waist-hip ratio: report of a WHO expert consultation. Geneva: World Health Organization (WHO); 2008 December 39p. ISBN9789241501491.

Misra A, Chowbey P, Makkar BM, Vikram NK, Wasir JS, Chadha D, Joshi SR, Sadikot S, Gupta R, Gulati S, Munjal YP. Consensus state-ment for diagnosis of obesity, abdominal obesity and the metabolic syndrome for Asian Indians and recommendations for physical activity, medical and surgical management.JAssoc Physicians India. 2009 Feb;57:163-70. Review. PubMed PMID: 19582986.[PubMed]).

World Health Organization; Home/Newsroom/Fact sheets/Detail/Obesity and overweight Available at: Assessed on 15/03/2022, 1.30pm).

World Health Organization; Home/Health topics/Obesity Available at: Assessed on 15/03/2022, 1.00pm.

Ben-Noun L, Laor A 2003 Relationship of neck circumference to cardiovascular risk factors. Obes Res 11:226-231. Doi: PMid:12582218

Ben-Noun LL, Laor A 2006 Relationship between changes in neck circumference and cardiovascular risk factors. Exp Clin Cardol 11:14-20.

Freedman DS, Rimm AA 1989 The relation of body fat distribution, as assessed by six girth measurements, to diabetes mellitus in women. Am J Public Health 79:715-720. Doi: PMid:2786346 PMCid:PMC1349629

Laakso M, Matilainen V, Keina¨nen-Kiukaanniemi S 2002 Association of neck circumference with insulin resistance-related factors. Int J Obes Relat Metab Disord 26:873-875. Doi: PMid:12037660

Saad MAN, Rosa MLG, Lima GB, Antunes da Cruz R Filho. Can neck circumference predict insulin resistance in older people? A cross-sectional study at primary care in Brazil. Cad SaudePublica. 2017 Aug 21;33(8):e00060916. Doi: PMid:28832779

Preis SR, Massaro JM, Hoffmann U, D'Agostino RB Sr, Levy D, Robins SJ, Meigs JB, Vasan RS, O'Donnell CJ, Fox CS. Neck circumference as a novel measure of cardiometabolic risk: the Framingham Heart study. J ClinEndocrinolMetab. 2010 Aug;95(8):3701-10. Doi: PMid:20484490 PMCid:PMC2913042

Sanjana SN, Davalagi S, Huchappa RK. Neck Circumference: A valid anthropometric tool to predict Obesity in Adults of Davanagere, South India. Indian J Comm Health. 2019;31(4):457-463. Doi:

Dudeja V, Misra A, Pandey RM, Devina G, Kumar G, Vikram NK. BMI does not accurately predict overweight in Asian Indians in northern India. Br J Nutr. 2001 Jul;86(1):105-12. Doi: PMid:11432771

Patnaik L, Pattnaik S, Rao EV, Sahu T. Validating Neck Circumference and Waist Circumference as Anthropometric Measures of Overweight/Obesity in Adolescents. Indian Pediatr. 2017 May 15;54(5):377-380. Doi: PMid:28368264

Sunil K, Gupta A, Jain S Neck circumference as a predictor of obesity and overweight in rural central India. Int. J. Med. Public health 2012; 2(1): 62-66. Doi:

Patil C, Deshmukh J, Yadav S, Patil S, Sheikh A Neck circumference: A novel anthropometric tool for screening obesity in adults In-ternational Journal of Collaborative Research on Internal Medicine & Public Health 2017; 9(7): 711-720.

Tantawy S, Kamel DM, Alsayed N, Rajab E, Abdelbasset WK Correlation between body mass index, neck circumference, and waist-hip ratio as indicators of obesity among a cohort of adolescent in Bahrain A preliminary cross-sectional study Medicine: 2020 Apr;99(17):e19950. Doi: PMid:32332676 PMCid:PMC7440259

Alfadhli EM, Alaa AS, Basma NZ, Mohammed AM, Reem FA, Tafani ST, Hanan AH Neck circumference as a marker of obesity and a predictor of cardiometabolic risk among Saudi subjects Saudi Med J 2017; Vol. 38 (12): 1219-1223. Doi: PMid:29209671 PMCid:PMC5787633

Aswathappa J, Garg S, Kutty K, Shankar V. Neck circumference as an anthropometric measure of obesity in diabetics. N Am J Med Sci. 2013 Jan;5(1):28-31. Doi: PMid:23378952 PMCid:PMC3560135

Verma M, Rajput M, Sahoo SS, Kaur N. Neck Circumference: Independent Predictor for Overweight and Obesity in Adult Population. Indian J Community Med. 2017 Oct-Dec;42(4):209-213. Doi: PMid:29184320 PMCid:PMC5682719

Joshipura K, Muñoz-Torres F, Vergara J, Palacios C, Pérez CM. Neck Circumference May Be a Better Alternative to Standard Anthro-pometric Measures. J Diabetes Res. 2016;2016:6058916. Doi: PMid:26981543 PMCid:PMC4766356

Yang GR, Yuan SY, Fu HJ, Wan G, Zhu LX, Bu XL, Zhang JD, Du XP, Li YL, Ji Y, Gu XN, Li Y. Neck circumference positively related with central obesity, overweight, and metabolic syndrome in Chinese subjects with type 2 diabetes: Beijing Community Diabetes Study 4. Diabetes Care. 2010 Nov;33(11):2465-7. Doi: PMid:20724650 PMCid:PMC2963514

Özkaya İ, Tunçkale A. Neck Circumference Positively Related with Central Obesity and Overweight in Turkish University Students: A Preliminary Study. Cent Eur J Public Health. 2016 Jun;24(2):91-4. Doi: PMid:27119655

Qureshi NK, Hossain T, Hassan MI, Akter N, Rahman MM, Sultana MM, et al. Neck circumference as a marker of overweight and obe-sity and cutoff values for Bangladeshi adults. Indian J EndocrMetab 2017;21:803-8. Doi: PMid:29285438 PMCid:PMC5729663




How to Cite

Shreedhar S, Naik PM, Geeta, Havale N, Manjula MN. Neck Circumference as A Screening Tool to Predict Obesity: A Cross Sectional Study in Coastal Karnataka, India. Natl J Community Med [Internet]. 2022 Nov. 30 [cited 2023 Feb. 4];13(11):782-7. Available from:



Original Research Articles