How should clients take body measurements and progress photos?
In short: Use a non-stretch tape and consistent anatomical landmarks to measure body circumferences. Where practical, take measurements under similar conditions each time, such as in the morning, and repeat readings to check consistency. For progress photos, use the same lighting, clothing, camera position and poses. Measurements and photos can be repeated every 2 to 4 weeks when appropriate, but the frequency should suit the client's goals and preferences.
1 min 23 s videoCaptions onUpdated 11 October 2026
Where to put the tape
Each site needs a landmark you can find again next month. If you change the landmark, you change the number, so write down which one you use.
| Site | Where to measure |
|---|---|
| Waist | Midway between the lowest rib and the top of the hip bone, at the end of a normal breath out |
| Hips | Around the widest part of the buttocks, with feet together |
| Chest | Around the chest at a consistent, recorded level, with arms relaxed at the sides |
| Upper arm | Midway between the bony tip of the shoulder and the point of the elbow, with the arm relaxed |
| Thigh | At a consistent, recorded distance above the kneecap, using the same leg each time |
| Neck | Around the neck at a consistent, recorded level, without compressing the skin |
Different organisations use different waist measurement protocols. The WHO uses the midpoint between the lowest rib and the top of the hip bone, while the US NHANES protocol measures just above the iliac crest. NICE also recommends the midpoint method. These approaches may produce different results, so use the same protocol for repeated measurements and follow the relevant guidance when interpreting clinical thresholds.
How to take a reading clients can compare
- Keep conditions consistent. Where practical, measure at a similar time of day. Morning measurements, after using the toilet and before eating or drinking, can be convenient for repeated comparisons.
- Use bare skin or consistent clothing. Measure directly against the skin where possible, or over the same type of thin, fitted clothing.
- Position the tape correctly. Use a non-stretch tape, keeping it flat against the skin and level around the body. A mirror can help check the position.
- Avoid compressing the skin. The tape should fit snugly without digging into the tissue.
- Breathe normally. For waist measurements, take the reading at the end of a normal breath out, without holding the breath or pulling the stomach in.
- Repeat the measurement. Take two readings to check consistency. If they differ noticeably, take another and review the tape position and technique. Record the method used so future measurements can be compared.
Taking your own measurements can be challenging, particularly when positioning the tape around the waist or hips. A mirror or another person's assistance may help. Consistent technique and anatomical landmarks are important when comparing measurements over time.
Waist-to-height ratio
Waist-to-height ratio is a simple measure used to assess central adiposity and associated health risk. NICE recommends using it alongside BMI for adults with a BMI below 35 kg/m². Calculate it by dividing waist circumference by height using the same units. A ratio below 0.5 is generally recommended, although results should be interpreted alongside other relevant health information.
Waist-to-height ratio = waist (cm) ÷ height (cm) Example: 88 cm ÷ 170 cm = 0.52
| Ratio (NICE, adults with BMI under 35) | Central adiposity |
|---|---|
| 0.4 to 0.49 | Healthy |
| 0.5 to 0.59 | Increased |
| 0.6 or more | High |
These categories describe central adiposity and associated health risk, rather than directly measuring visceral fat or body-fat percentage. They are intended for adults. Children and young people require age-appropriate assessment, and waist-to-height ratio should not be used to assess central adiposity during pregnancy.
Progress photos that compare fairly
- Same place, same plain background, same light. Facing a window in daylight works, overhead lighting changes the shadows.
- Camera at chest height, about 2 m away, on a tripod or propped on a shelf with a timer. Mark the spot on the floor.
- Same fitted clothing, or underwear, every time.
- Front, side and back, standing relaxed with arms slightly away from the body. No posing, no flexing.
- Same time of day as the measurements.
Progress photos are optional and should only be collected when appropriate and agreed with the client. Photographs collected for health or body-composition monitoring may constitute sensitive personal data. Explain why they are being collected, where they will be stored, who can access them and how long they will be retained. Obtain separate, documented permission before using identifiable client photographs for marketing.
Measurements and progress photos may not be appropriate for every client. For someone with current or previous disordered eating, or who experiences distress around body monitoring, consider whether these methods are necessary or helpful. Alternative indicators of progress may include strength, fitness, energy, sleep and other relevant health or performance outcomes. Agree the approach with the client and seek specialist input where clinically appropriate.
How often, and what to look for
For general progress tracking, measurements and photographs every 2 to 4 weeks can provide a practical balance between monitoring changes and avoiding unnecessary frequency. The appropriate interval depends on the client's goals, preferences and circumstances.
Interpret measurements as trends rather than isolated results. Waist circumference can vary with factors such as bloating, fluid retention and measurement technique, while body weight can fluctuate from day to day.
A reduction in waist circumference alongside stable weight may suggest changes in body composition that aren't reflected on the scales alone. However, circumference measurements cannot confirm changes in fat or muscle mass independently.
If body weight and circumference measurements remain unchanged over several weeks, review the broader picture, including dietary intake, activity, adherence and the client's goals, before deciding whether adjustments are needed. For further guidance, see what to do about a weight loss plateau.
How to do it in Foodzilla
In Foodzilla, you and your client both log weight, body fat, eight circumference sites and progress photos, and they all sit on the client's dashboard. The video shows logging a check-in and reviewing the history.
- 1Open the client's dashboard, choose More, then Log Weight.... On the Weight tab, enter weight and body fat percentage and upload up to 5 progress photos, 10 MB each.
- 2Switch to the Body measurements tab and enter any of neck, chest, waist and hips, left and right thigh, and left and right biceps, in cm or inches to match the client's units. Press Save.
- 3Clients log their own in the Foodzilla app. Log Weight opens Body Metrics, where they add weight, body fat, body measurements and progress photos, then press Add to Diary.
- 4To collect measurements as a regular check-in, go to Forms & Bookings, find Progress Check & Body Measurements under Templates, press Use template and then Save Form, and press Send... on your copy (Professional plan and above). The weight, waist, hips, chest and body fat a client enters go straight into their measurement history.
- 5To review, open the Body Measurements section on the client's dashboard and press Weight History & Progress Photos.
- 6Customise body tracking. If you and your client agree that body measurements or progress photos aren't appropriate or helpful, you can hide Body Tracking in their app settings: choose More, then App Experience..., turn off Body Tracking and press Save Changes. This allows you to tailor the client's experience to their individual needs and preferences.
Good to know
- Write the landmark downRecord the measurement location in the client's notes, such as 'waist at midpoint' or 'thigh 15 cm above kneecap'. This helps the client or another practitioner use the same anatomical landmarks at future assessments.
- Pair photos with the tapeIf using both measurements and progress photos, consider collecting them on the same day under similar conditions. This makes it easier to compare changes over time without collecting more information than necessary.