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Symptoms and secondary disorders associated with excess central fat distribution are being increasingly recognised. We aimed to define the symptoms and assess risks of chronic disorders in people with large waist circumferences.

We did a cross-sectional study of 5887 men and 7018 women aged 20–59 years from the general population of Maastricht, Amsterdam, and Doetinchem, Netherlands. We assessed in health centres respiratory insufficiency, low back pain, degree of physicical function, presence of non-insulin-dependent diabetes, and cardiovascular risk factors. We measured bodyweight, body-mass index, and waist circumference by action levels (men: less than action level 1 <94·0 cm, action levels 1–2 94·0–101·9 cm, more than action level 2 ≥102·0 cm; women: less than action level 1 <80·0 cm, action levels 1–2 80·0–87·9 cm) more than action level 2 ≥88·0 cm). The reference …