Body Shapes and How They Affect Your Health – Cleveland Clinic

Our genetics play a role in determining where our weight takes up residence in our bodies. Some people are more likely to gain weight around the waist, while others are more likely to see the weight gain travel to the hips. It’s just like that. People come in all shapes and sizes, and our genes predispose us to carry our weight in different places. It’s normal.

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There’s no “right” or “wrong” or “good” or “bad” when it comes to your body shape. Just like there is no “right” or “wrong” height. It’s just something you don’t have much control over.

But where you naturally carry your weight can have a big influence on your health if you live with overweight or obesity. Excess weight in certain parts of your body, particularly around your belly, can put you at greater risk for serious conditions.

“Your body shape doesn’t necessarily mean much about your health if you live in a healthy weight range,” says internal medicine physician Elena Borukh, MD, an obesity and diabetes specialist. “It’s more a question of where extra weight lies that make a difference in terms of risk for some chronic diseases.

We spoke with Dr. Borukh about what your body composition can mean for your health and how you can reduce your risk of chronic health conditions.

What build do you have?

When considering your body shape and its impact on your health, you’ll want to consider two things:

  1. The natural distribution of weight in your body, i.e. where your body curves (and where it doesn’t).
  2. Your body mass index (BMI).

Your body shape is a description of where on your body your weight tends to fall. (It’s not a very scientific standard, but it’s something most of us can easily relate to.)

Your BMI, on the other hand, is a measure that helps you and your doctor know if you’re living in a healthy weight range. It is a measurement that takes your weight and height into account to assess your health. (As Dr. Borukh points out, BMI isn’t always a reliable number, but it’s a good place to start.) A BMI of 25 or higher is considered overweight. Obesity is defined as a BMI of 30 or more.

Your provider may also use measurements such as waist circumference or ratios such as waist-to-hip measurements, to get a better picture of your health and risks. Some providers may also use body composition machines to assess muscle mass and more to gain an even more personalized understanding of your health.

Your body shape in itself doesn’t necessarily indicate whether you’re healthy or unhealthy, notes Dr. Borukh. Rather, it’s a combination of your body shape and an unhealthy BMI that can be a red flag for certain conditions.

In general, people fit into one of five standard body shapes:

  • Apple: Rounder in the center.
  • Pear: Lower half wider.
  • Inverted triangle: Looser at the shoulders and chest with a narrow waist and bottom.
  • Ruler: More or less straight up and down.
  • Hourglass: Proportionate chest and hips with a smaller midline.

Dr. Borukh breaks down each of these body types and the health risks associated with being overweight or obese for each.

Shaped like an apple

People with a so-called “apple” body shape carry more weight around their midsections. Having a full waist, or “abdominal obesity,” can be a red flag that you may be at risk for conditions like heart disease and diabetes.

The U.S. Centers for Disease Control and Prevention (CDC) states that a waist circumference greater than 35 inches in women and those assigned female at birth or 40 inches in men and those assigned male at birth may be a factor in risk for obesity-related conditions. To measure waist circumference, stand up and wrap a tape measure around your waist, just above your hipbones. Keep the tape snug but do not compress the skin.

“Research has repeatedly shown us that belly fat is the most concerning type, so an apple shape may be a cause for concern in people with overweight and obesity,” says Dr. Borukh.

This is because people with apple shapes are more likely to store unhealthy amounts of visceral fat. Unlike subcutaneous fat, which lives just under the skin, visceral fat is found deep within the abdominal walls. It surrounds the stomach, liver, intestines and other organs.

“Visceral fat raises insulin levels, which means your body makes more insulin than it needs,” explains Dr. Borukh. “An increased level of insulin or insulin resistance is the main driver of metabolic syndrome, which can be a precursor to diabetes and also puts you at a higher risk of heart disease and stroke.”

She says people who are apple-shaped can reduce their risk of these conditions and more by maintaining a healthy weight and waist circumference.

Eating a balanced diet, one that emphasizes lean protein and whole foods, rather than prepackaged choices, can help.

Additionally, for those who are able, following exercise guidelines to get at least 150 minutes a week of cardio exercise and strength training twice a week is important for keeping your weight at a healthy level. Ab workouts like crunches, planks, and leg raises can help strengthen your core and shed visceral fat. Any exercise you can do is better than none.

Pear shape

“Pear-shaped” people have a narrow upper body and fuller in the hips and lower body.

Overweight or obese people who are pear-shaped may be at higher risk for varicose veins and osteoarthritis in the lower joints (such as the hips and knees). This is because excess weight in the lower body can put pressure on the legs.

“We thought having a pear shape was more protective,” says Dr. Borukh. “But some studies are now showing that people who carry excess weight in their lower half may also be at risk for visceral fat, so they may have similar risks to those with an apple shape.”

If you carry more weight in your lower body, a healthy diet and exercise can help protect you from health problems. People with pear shapes may also benefit from exercises that target the lower body, such as:

Inverted triangle

People with an inverted triangle body composition carry more weight in their upper body, such as their chest and shoulders, than their stomach and hips.

If you’re carrying more weight overhead, you may be more prone to some significant aches and pains. People with an inverted triangle body shape are more likely to experience back, shoulder and neck pain.

Breast reduction surgery and gyno surgery may be an option for some people who experience back pain due to larger breasts or chest.

People with inverted triangle shapes can also improve their health by keeping their waist size in a healthy range through diet and exercise. Workouts that strengthen the back can also ease discomfort.


If your body shape has less defined curves, you may be more of a ruler or column body type. A ruler shape may look like it translates to “skinny” or underweight, but it doesn’t necessarily.

“People can have a ruler shape and be in a healthy weight range,” says Dr. Borukh. “Or you can be ruler-shaped and be underweight, overweight, or obese. A ruler shape means your body is more in a straight line, which isn’t necessarily indicative of your BMI.

People who have a ruler shape may be more prone to having smaller, thinner bones, which can be a risk for fractures and osteoporosis. You can reduce your risk of fractures with exercises that stimulate bone growth.


An hourglass shape is characterized by having an upper and lower body in proportion to each other with a defined waistline.

Remember, however, that a “defined” waist is relative to the rest of your body. So, people with an hourglass shape may still be at risk for visceral fat and other conditions if their BMI is 25 or higher.

How to maintain healthy fitness

Let’s say it again. Your body shape isn’t necessarily a health issue. It’s a natural distribution of your weight. Any body shape can be healthy.

It’s when you live with being overweight or obese that your natural shape can become a health risk.

Eating right and exercising regularly are key to keeping your weight in a healthy range and keeping your body strong.

But how do you get started, especially if you live with limitations that make exercise particularly challenging?

Dr. Borukh suggests swimming and water aerobics for a low-impact, full-body workout that can be tailored to your abilities and needs. A healthcare professional can help you create a diet and exercise plan that will be most effective for you.

Your body shape is part of what makes you… you. It is unique, individual and natural. And while you can’t change where your weight chooses to settle, know that any effort you make to keep your weight in a healthy range will be good for your body.

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