Waist‑to‑height ratio tracking instead of scale
Berg argues that visceral fat is the real enemy — it drives inflammation, insulin resistance, and organ dysfunction. A tape measure around the midsection is a cheap, immediate proxy. He explains that some people lose visceral fat rapidly (within days or weeks) without seeing scale changes because the fat is being removed from the liver and pancreas while water weight, muscle, or bowel contents mask the loss. The 0.5 cut‑off is simple: if your waist is less than half your height, your visceral fat is in a healthy range. He contrasts this with the scale, which can show zero progress for weeks even as dangerous fat is disappearing.
Visceral fat accumulates inside the abdominal cavity, expanding waist circumference. This fat is highly metabolically active and pours fatty acids into the portal vein, damaging the liver. Reducing it directly shrinks the waistline. Because visceral fat correlates more strongly with metabolic disease than BMI or total weight, tracking waist‑to‑height ratio aligns the measurement with the biological target.
Berg has used this metric with thousands of patients and finds it both more encouraging and more accurate than weight for assessing progress.
A much better, more accurate way to know that you're losing visceral fat is the waist to height ratio measurement. … You want your waist to be less than half of your height. … As it starts to go down, you can rest assured that you're losing visceral fat.

