Pilates guide
Pilates won't narrow your waist from one spot. No exercise takes fat off the part of the body it works, and in the Pilates trials that measured the waist, it changed by a few centimetres at most, about as much as with walking and often no more than with no exercise at all. Your waist size comes from fat under the skin and around the organs, the muscles of your trunk, what's in your gut, and the bones of your ribs and pelvis, which no exercise changes.
What Pilates does well is build a stronger trunk: the side bend, the criss-cross, the saw and side planks work your obliques hard, and Pilates counts towards your two strength days a week. A waist gets smaller, if it does, with the rest of you, through moving more and eating a little less.
This guide covers what sets your waist size, what the trials show, your obliques and deep core, whether Pilates can make your waist wider, waist trainers, your waist and your health, and a week built from our classes. Bodies come in many shapes, and nothing here promises a particular one.
Training one part of the body didn't take fat off it across 13 controlled studies, and ab exercises didn't shrink the waist in small trials. No method picks which fat goes: "No intervention preferentially targets visceral fat."
Two reviews found no significant change in waist size (about 2.7 cm and 3.6 cm less, from 2 or 3 small trials each). Against walking, the waist fell about equally. Most reviews of Pilates and body composition are low quality.
It's fat under the skin and around the organs, the trunk muscles, what's in your gut, and the bones of your ribs and pelvis. How you stand changes the tape too: drawing the tummy in, as in the Pilates stance, read up to 5.2 cm less.
Each extra 30 minutes a week of aerobic activity took about 0.56 cm off the waist, with 150 minutes a week or more for a worthwhile change. Deep belly fat falls with exercise even when the scales don't move.
The criss-cross, side planks and the dead bug work the obliques hard, and the hundred and roll-up switch on the deep tummy muscle while you do them. Pilates counts towards your two strength days a week.
The side muscles grow by millimetres, not centimetres, and no study has measured the waist after side bends (our reading). No trial shows a waist trainer gives a lasting smaller waist, and tight compression can make reflux worse.
Five things set the number on the tape, and exercise can change two of them. Our guide to a smaller waist sets out the anatomy in full.
The fat you can pinch sits under the skin; visceral fat sits deeper, around the organs inside your tummy. With every weight-loss method studied (diet and exercise, medicines and surgery), the two fell together: "Visceral fat loss is linked to subcutaneous fat loss." That's why no move, and no Pilates class, picks which fat goes or where it goes from. Our Pilates for belly fat guide covers the two kinds.
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The external and internal obliques run diagonally round your sides, the transversus abdominis lies deepest and wraps your trunk like a belt, and the rectus abdominis (the six-pack) runs down the front. Pilates calls the trunk the powerhouse. Its side and twisting moves load the obliques: one teaching platform's guide to the classical mat says the saw "will work the abdominals, obliques, and back extensors" and the spine twist will "strengthen the obliques and back extensors".
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Food, fluid and gas add to the tape, so your waist reads more after a meal or when you're bloated, sometimes by a few centimetres within a day. Our Pilates for bloating guide covers the gut side.
The bottom of your ribcage and the top of your pelvis set the frame, and no exercise changes bone. An hourglass outline depends on your hips, your shoulders and where your body keeps fat as much as on your waist (our reading, as our guide to a smaller waist explains).
In 48 women with a median age of 60, the Pilates stance (drawing the tummy in and up) gave a waist up to 5.2 cm smaller than the usual clinical stance, and the authors recommend the clinical stance for repeated measuring. The World Health Organization (WHO) notes that "increasing the tension (by sucking in) reduces waist circumference". A before and after in two different stances measures posture, not fat.
Where your body stores fat is partly inherited and partly set by sex and age; around the menopause, fat tends to move towards the middle. After a pregnancy, your tummy can stay rounder for months, as the NHS post-pregnancy body page explains, and our Pilates for diastasis recti guide covers the gap between the six-pack muscles.
Across 13 controlled studies of 1,158 people aged 14 to 71, training one limb against the other: "spot reduction was not observed". The review pooled limb studies, not trunk exercise, but nothing suggests the trunk behaves differently (our reading). And whichever way fat is lost, "No intervention preferentially targets visceral fat."
In 24 inactive adults, 7 ab exercises 5 days a week for 6 weeks, with diet held steady, changed neither the waist nor the fat over the tummy, though the curl-up test improved. In 40 women on a diet, adding 12 weeks of ab resistance training "did not reduce abdominal subcutaneous fat thickness compared to diet alone". Both trials were small.
In 16 men, torso rotations and crunches plus treadmill running took a little more fat off the trunk on a DXA (dual-energy X-ray absorptiometry) scan than running alone, but the sessions lasted almost twice as long, and "Waist circumference also decreased in both groups", by about 5 cm, "with no difference between the groups present." A circuit study's local result came from one group of 14 people.
Our search found no Pilates trial that measured fat at the sides of the waist, or deep belly fat on a CT (computed tomography) or MRI (magnetic resonance imaging) scan.
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The Pilates waist results rest on a few small trials, many in journals few researchers read, and on body-fat scales that scans often don't confirm.
In adults with overweight or obesity, 11 trials (393 adults) found Pilates lowered weight by about 2.4 kg against no exercise, mostly in programmes longer than 10 weeks, but "Pilates has no significant effect on waist circumference" (about 2.7 cm less, from 2 small trials of 8 weeks). In adult women, the newest review found "the pooled analysis did not show a statistically significant effect of Pilates on waist circumference" (about 3.6 cm less, from 3 studies and 101 women), and no effect on waist-to-hip ratio.
Read in full, one of the newer review's waist trials reports an 8.45 kg weight loss in 8 weeks of Pilates with no diet described, and another, with 12 women a group, found no significant waist difference and contradicts itself on changes within the groups. Of 27 meta-analyses of Pilates, 25 were rated low or critically low quality.
In 44 adults with overweight doing 3 hours a week for 8 weeks with no change to their diet, the waist fell by 2.6% with Pilates and 3.3% with walking, and "There was no difference in body composition between groups". A Pilates circuit and a weights circuit changed the waist-to-hip ratio about equally in 18 women. Across 10 studies, mat Pilates was no better than other exercise or no exercise for body mass index (BMI), body fat or the waist.
In 19 Pilates-trained women, 10 weeks of reformer and Cadillac classes moved the waist by an amount that only approached significance, and a bioimpedance scale showed fat loss that the DXA scan didn't. A reformer trial in 47 women with overweight measured body fat with a bioimpedance scale and didn't measure the waist. Many reports of Pilates burning fat rest on such scales (our reading).
In 90 women with prediabetes or type 2 diabetes, "No significant between-group differences were found in metabolic or body composition outcomes." Twice-weekly Pilates or yoga for 8 weeks didn't change body composition, which the authors put down to the low amount of exercise. One trial after breast cancer reported a large waist fall with mat Pilates that fell in the comparison group too and had come back at follow-up.
In 35 first-time mothers about 6 months after the birth, 4 weeks of Pilates 5 days a week narrowed the gap between the six-pack muscles and the waist a little against no exercise, in a trial that doesn't describe its allocation as random. Our Pilates for diastasis recti guide covers this.
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These are mostly single lab sessions: they show which moves use the muscles, not what changes over weeks or what happens to the fat over them.
In 32 beginners, "The criss-cross exercise presented the highest values of root mean square for trunk flexors (rectus abdominis and oblique) compared with the other exercises, followed by the single leg stretch and the dead bug". A side bridge with a twist worked the outer oblique at 62.8% of its maximum in 25 adults. A Pilates roll-up worked the outer oblique about as hard as a curl-up, and Pilates ab moves worked the upper six-pack more than a crunch in 17 women.
The hundred, roll-up and leg circle thickened the transversus abdominis and inner oblique on ultrasound in experienced practitioners, and of five Pilates moves in 44 women, the dead bug did so most. But in a pilot trial, "There were no changes in muscle thickness at rest or during functional postures.", and "Pilates training appears to increase TrA activity but only when performing Pilates exercises." (TrA is the transversus abdominis.) So it doesn't hold your waist in when you stop (our reading).
In 9 inactive women on MRI, 36 weeks of twice-weekly Pilates grew the outer oblique on the dominant side by 8%, with no change on the other side and no control group. Small uncontrolled ultrasound studies report thicker side muscles after 8 weeks, a year of Pilates in 17 people showed no clear thickening, and twisting exercise added millimetres in 73 adults over 4 weeks.
Professional tennis players had "18% greater volume in the non-dominant than in the dominant OT" (OT is the outer oblique) on MRI: years of elite rotation, not a class twice a week.
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Our searches found no study that measured waist size after oblique training, side planks or weighted side bends, and no scan study of ab training that measured the waist.
The muscle changes measured after Pilates or twisting are small: 8% of oblique volume on one side after 36 weeks, and millimetres on ultrasound. Whole-body activity moves the waist by centimetres. So ordinary Pilates is very unlikely to make a waist visibly wider; that's our reading of these studies, not a trial result. In one small study, trunk training grew trunk muscle with no change in body mass or body fat: a stronger trunk, not a bigger or smaller one.
Weight going up for other reasons, bloating, measuring in a different stance, or a different spot on your tummy (our reading). "The protocol selected to measure waist circumference should be used consistently." A waist that keeps growing with no clear reason is a reason to see a GP (see the warning signs).
Across 116 trials of 6,880 adults with overweight or obesity, each extra 30 minutes a week of aerobic training took about 0.56 cm off the waist (high certainty), and "aerobic training exceeding 150 minutes per week at moderate intensity or greater may be needed to achieve clinically important reductions". Across 25 trials, regular aerobic exercise took about 3.2 cm off the waist, which "can occur with negligible weight loss". In 300 adults over 24 weeks, every exercise group lost about 4 cm more waist than people who didn't exercise, and harder or longer sessions added little.
In 43 trials of women with overweight or obesity, moderate to vigorous aerobic training was the only kind of exercise that clearly beat no exercise for the waist (no trial in it tested Pilates). After the menopause, aerobic training took about 2 cm off the waist (moderate certainty); in older adults, about 2 cm, at the edge of significance.
"In the absence of weight loss, exercise is related to 6.1% decrease in VAT, whilst diet showed virtually no change (1.1%)." (VAT is visceral fat.) Every main type of exercise cut visceral fat across 60 trials, and exercise cut belly fat under the skin by 9.1% and visceral fat by 7.1% in 12 trials. "Exercise-induced or diet-induced reductions in waist circumference are observed with or without weight loss."
Eating less cut visceral fat more than exercise did across 40 trials, and both helped. NICE (the National Institute for Health and Care Excellence) encourages activity for people living with overweight or obesity even if they don't lose weight.
The NHS lists Pilates among muscle-strengthening activities: adults should strengthen on at least 2 days a week, alongside at least 150 minutes of moderate activity. Pilates is light work for the heart, like a slow walk, so it counts towards your strength days rather than your brisk minutes, as our Pilates for love handles guide explains.
Brisk activity on most days, building towards 150 minutes a week or more; Pilates twice a week as your strength days, with the side-body moves below; a little less to eat, without a restrictive diet, if you want to lose weight; and, if it suits you, a tape measure every few weeks. Expect the waist to change over months, with the rest of you, and partly not at all, because part of it is bone. This is our editorial plan, built on the sources above.
NICE uses the waist-to-height ratio for adults with a BMI under 35: 0.4 to 0.49 means no increased health risks, 0.5 to 0.59 increased, and 0.6 or more further increased, with type 2 diabetes, high blood pressure and heart disease among the risks. The NHS says: "You should try to keep your waist size to less than half your height." Across 31 papers and more than 300,000 adults, the ratio picked out heart and metabolic risks a little better than BMI, and it worked in older adults too.
In 72 cohorts of 2.5 million people, each 10 cm more waist went with an 11% higher death rate, after allowing for BMI. These are risks across large groups, not a verdict on any one body.
Find the bottom of your ribs and the top of your hips, wrap the tape midway between them (just above your belly button), and "breathe out naturally before taking the measurement", as NICE says. The NHS adds: "Breathe out naturally, do not hold your tummy in and take your measurement." Some research measures at the top of the hip bone instead, so measure the same way each time.
The WHO report's waist cut-offs (94 cm for men and 80 cm for women for increased risk, and 102 cm and 88 cm for substantially increased risk) are for white European populations, and it lists 90 cm for South Asian, Chinese and Japanese men. NICE says people of South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean background carry more risk at a lower BMI.
NICE asks professionals to explain these risks "in an inclusive and non-stigmatising way". The NHS calculator isn't for use if "you are pregnant" or if "you have been diagnosed with an eating disorder, or think you may have one". If measuring makes you anxious, leave the tape alone and go by how you feel and what you can do (our suggestion). Our waist-to-height ratio calculator does the sums.
Our searches found no study of waist trainers or waist-training corsets that measured the waist after the garment comes off. The one randomised corset trial, after a very-low-calorie diet in 77 adults, couldn't be judged: "Compliance with corset was only 20% after three months."
A light compression garment plus eating goals gave 1.3 kg more weight loss over 12 weeks, with no significant waist difference, in a trial whose authors worked for the garment's maker. They add that its pressure "is minimal compared with that of a tight girdle or corset".
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A tight belt made acid reflux "approximately 8-fold" more common in 14 people with reflux disease, and a compression binder pooled blood in the legs when lying down in 25 healthy adults. Serious harm is rare and comes from single case reports: a blocked leg artery days after liposuction, and a bleed under the liver's capsule.
A rigid belt or a tube bandage didn't close the gap between the six-pack muscles faster than expected natural healing, in a trial with no untreated group.
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Drawing in narrows the tape only while you hold it. A review of 5 hypopressive studies in healthy women reported smaller waists but concluded "we cannot recommend its practice due to the serious methodological problems", and in 13 trials of hypopressive techniques, 12 were at high risk of bias. Our search found no controlled trial showing a lasting change in resting waist size.
Brisk walk: 20 minutes, at a pace where you can talk but not sing, and marching on the spot: 2 minutes, to warm up (both our walk and Pilates workout); step jack, with no jumping: 30 to 45 seconds within a circuit, 2 to 3 rounds (from the move page's dose).
Lateral breathing: 5 to 8 breaths at the start of every session; knee fold: 2 sets of 5 to 10 each side, every other day (both from the move pages' doses), head down and pelvis still; dead bug heel taps: 6 each side (our Pilates for back pain class).
Hundred: 50 beats to start, building to 100 (the classical count); chest lift: 8 to 10 reps; single-leg stretch: 6 to 10 each side (all from the move pages' doses). Keep your head down with osteoporosis or a sore neck.
Criss-cross: 6 each side, slowly; saw: 3 to 4 each side, twisting without rounding if you have osteoporosis; spine twist: 3 to 4 each side (the classical sequence uses 3) (all from the move pages' doses); open book, the gentle twist, lying down: "8 to 10 slow openings each side, pausing 2 seconds at the end (our editorial starting point); ACE suggests 5 to 10." (the move page's dose; ACE is the American Council on Exercise).
Knee side plank: 2 holds of 20 s each side (our Pilates for golfers class); side plank: 15 to 40 s each side, easier on your knees (our oblique workout); side bend: 3 to 5 each side (the classical sequence uses 3), once a 20-second side plank feels steady; mermaid: 3 each direction, each side (both from the move pages' doses); overhead side bend: 3 slow bends per side, exhale into each (the move page's dose).
Forearm plank: 30 s (our 10-minute Pilates abs class); bird dog: 6 each side (our Pilates for posture class); knee hover: 3 holds of 15 to 30 seconds (from the move page's dose), on fists or forearms for sore wrists.
Pallof press: 10 each side, and suitcase carry: 20 m each hand (both our oblique workout), for when you want your side muscles to hold you steady against a pull.
Our suggestions, unless a source is given.
There's no good evidence that either gives you a smaller waist, as our guide to a smaller waist explains.
A corset during Pilates also stops your trunk muscles doing the work the class is for (our reading).
None is needed here. Weighted side bends neither widen nor slim the waist in ordinary training, and no study has measured it; keep twists slow and comfortable (our suggestion).
With osteoporosis, leave out the weight in the Russian twist and twist only as far as is comfortable; after a spinal fracture, ask a physiotherapist first.
These advanced classical moves carry neck, osteoporosis and hip replacement cautions on their move pages. Leave them to our classical mat exercises guide (our suggestion).
Breathe out as you lift, and don't hold your breath.
The reformer's short box series twists and side bends against the springs. It has no 3D demo here; our reformer Pilates guide describes it (our suggestion).
Our editorial plan, built from the NHS activity and strength guidelines, the aerobic dose trials and NICE's advice on activity, and the same week our Pilates for love handles guide gives. It's a starting point, not a prescription.
See the movement on the 3D figure: Treadmill walking
There's no waist class on purpose: no set of moves narrows a waist. Start with the walk and Pilates workout, a brisk walk for your waist and then Pilates for strength; its tips add that in an 8-week trial the waist shrank by about 3 cm with Pilates or walking while the scales barely moved. The abs and golfers classes hold the side-body moves, the oblique workout and the strength workout add load, and the plus-size, chair and postnatal classes are other ways in.
A 45-minute session for weight loss and health: a 20-minute brisk walk, which does more for the scales, then a short-rest Pilates circuit for strength.
45 minBeginner11 movesCardio machineTen minutes of the classic Pilates abdominal series: the hundred, the roll-up and the series of five, with a plank to finish.
10 minIntermediate11 movesNo equipmentA 25-minute Pilates class for golfers: upper-back and hip rotation, trunk control, side-hip strength and one-leg balance, done equally on both sides.
25 minBeginner19 movesWallA 25-minute oblique workout at home: side planks, a band Pallof press and a suitcase carry to hold your trunk steady, then slow Russian twists and side-lying crunches.
25 minIntermediate8 movesBand, anchor pointA 30-minute Pilates strength class with dumbbells or a band: Pilates trunk work plus squats, lunges, rows and push-ups, each set taken until it is hard.
30 minIntermediate15 movesDumbbell, bandA 30-minute intermediate mat Pilates class that follows the classical order, from the hundred to the push-up, with prep versions of the hardest moves.
30 minIntermediate22 movesNo equipmentA 25-minute core strength workout: planks or rollouts, side planks, a band Pallof press, bird dogs, curl-ups and a carry, each with an easier and a harder step.
25 minBeginner11 movesAb wheel, bandA 25-minute standing cardio circuit with no jumping: marching, step jacks, sit-to-stands, punches, step-ups and wall push-ups, with a seated option for most moves.
25 minBeginner9 movesBench or box, stepA 30-minute Pilates class for bigger bodies: a standing warm-up, wall and chair strength, a supported way down to the mat and up, mat moves and a seated cool-down.
30 minBeginner18 movesBench or box, wallA 20-minute chair Pilates workout for beginners and older adults: breathing, sitting tall, gentle spine and leg moves, and a standing finish at the chair.
20 minBeginner14 movesBench or box, something with weightA 20-minute postnatal Pilates class: breathing and pelvic floor, lying, side-lying and hands-and-knees moves, upper back work for feeding and a standing lift.
20 minBeginner16 movesBench or boxThe walking plan builds up to 150 minutes a week over 8 weeks; the weight loss plan mixes strength and cardio; the 4-week Pilates plan and the wall Pilates challenge are gentle ways to start. None promises a new shape.
A free 8-week walking plan for beginners: build to 150 minutes of brisk walking a week, with intervals, hills and two short strength sessions.
6 training days40 minBeginner5 days a weekA 12-week workout plan for weight loss: three strength days, two cardio days and daily steps, building to 200 minutes a week, with honest results.
3 training days45 minBeginner3 days a weekA free 4-week, 3-day Pilates plan for complete beginners. Two mat days and one wall day, with clear rules for when to move each exercise to its harder version.
3 training days25 minBeginner3 days a weekA free 30-day wall Pilates challenge for beginners: three 20-minute wall classes a week that get harder step by step, with an honest look at the 28-day trend.
3 training days20 minBeginnerWaist searches are often body worries as much as fitness questions. Your waist isn't a problem to fix.
Health risk follows your waist compared with your height, not the look of your sides, and the UK Chief Medical Officers say activity improves physical health whatever your weight. Bodies come in many shapes.
The NHS lists signs such as spending a lot of time worrying about your weight and body shape, exercising too much, and having very strict habits or routines around food. If that sounds like you, see a GP as soon as you can. You can also talk in confidence to the eating disorder charity Beat: 0808 801 0677 (England), 0808 801 0432 (Scotland), 0808 801 0433 (Wales) or 0808 801 0434 (Northern Ireland), 3pm to 8pm, Monday to Friday.
If you worry a lot about one area of your body, spend a lot of time comparing your looks with other people's, or check or avoid mirrors, it can be body dysmorphic disorder (BDD). The NHS says "You should see a GP if you think you might have BDD." You can also refer yourself to NHS talking therapies (our suggestion, from the NHS page).
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In a survey of 2,287 young adults, women who did yoga or Pilates had disordered eating as often as those who didn't, and men who did them reported more extreme weight-control behaviours (18.6% against 6.8%). Set goals for strength, control and how you feel, not calories burned.
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Start where you're comfortable: chair, wall and standing versions all count. Our Pilates for plus-size bodies guide covers getting up and down from the floor and the equipment that helps.
Ask your midwife or doctor first. From the end of the first trimester, keep moves on your back short, prop your upper body up, or switch to side-lying, all-fours or standing versions, as our walk and Pilates workout says.
In pregnancy, after the first trimester, keep time flat on your back to a few minutes: prop your upper body up, or use a side-lying or all-fours version.
The look of your tummy after pregnancy isn't only fat, as the NHS post-pregnancy body page explains. Follow our Pilates for diastasis recti and postnatal Pilates guides, and stop the criss-cross or wall hundred if your tummy domes, as their pages say.
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Keep your head down in the hundred and single-leg stretch, as our walk and Pilates workout advises, or choose the dead bug, bird dog and planks instead of the curl-up moves. Our Pilates for osteoporosis guide has more.
With osteoporosis, leave out the weight in the Russian twist and twist only as far as is comfortable; after a spinal fracture, ask a physiotherapist first.
With back pain, nothing is banned: keep pain mild and settling, and let your tummy stay relaxed rather than braced.
With a hernia, stop any move that makes it hurt or bulge, and see a GP if you think you have one.
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Breathe out as you lift, and don't hold your breath.
These are the warning signs from our smaller waist, love handles and Pilates guides, word for word, apart from the two lines marked as our suggestion. This is general information, not a diagnosis. A&E means accident and emergency; in the US, call 911 for 999, and use your doctor's urgent line or urgent care for NHS 111.
Call 999 if:
Call 999 or go to A&E (accident and emergency) straight away for severe difficulty breathing (gasping, choking or not able to get words out), a chest that feels tight or heavy, pain that spreads to your arms, back, neck and jaw, lips or skin turning very pale, blue or grey, or sudden confusion. If you're more short of breath than usual, or your heart is racing, fluttering or skipping beats, contact NHS 111.
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If you have bloating with a swollen stomach and a stomach ache that is severe and came on very suddenly, you're vomiting blood or your vomit looks like ground coffee, or you have severe difficulty breathing. Don't drive yourself to A&E. During exercise, stop and get help for chest pain or pressure, unusual breathlessness, dizziness or fainting, as our plans advise.
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If you have bloating with being sick, diarrhoea or constipation, or with a stomach ache; a high temperature, or you feel hot, cold or shivery; a swelling or lump in your tummy; a burning feeling in your chest caused by stomach acid travelling up towards your throat (acid reflux); or you can't pee, poo or fart. In the US, contact your doctor or urgent care.
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For a bulge in your groin or tummy that is painful, or comes with a swollen tummy, being sick or constipation, as our guide to exercise for men explains. In the US, contact your doctor or urgent care.
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If you feel bloated regularly, or have bloating with weight loss you can't explain or blood in your poo: the NHS says bloating that doesn't go away can sometimes be a sign of something more serious, such as ovarian cancer.
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If you're losing weight without trying, see a GP: the NHS says it "can be a sign of stress or a serious illness" (our suggestion, from the NHS page).
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The NHS lists health conditions that cause weight gain, such as an underactive thyroid, Cushing's syndrome and PMOS (polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome), and "certain medicines including some steroids, antidepressants and beta blockers". It says: "Speak to a GP for advice if you have a condition that makes it harder to stay a healthy weight." Don't stop a medicine without talking to your doctor (our suggestion).
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The NHS suggests seeing a GP if your BMI is in the overweight or obese range and you want help to lose weight, your waist is more than half your height, or you have conditions such as diabetes, high blood pressure or sleep apnoea.
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If you take insulin or a sulfonylurea, exercise can bring on a hypo: see our type 2 diabetes guide. If you're on weight loss injections, see the exercise advice in our exercise for weight loss guide.
See a GP if lifestyle changes and pharmacy medicines aren't helping, you have heartburn most days, or you also have food getting stuck in your throat, are often sick or are losing weight for no reason (our suggestion, from the NHS).
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Take off a waist trainer or tight garment, and don't wear it again, if it brings on more reflux or heartburn than usual, makes breathing harder, or brings swelling, coldness, numbness or pain in your legs (our suggestion, from a small study of tight belts and reflux, a study of compression binders and a case report).
If you have a heart condition, follow your cardiac team's advice on how hard to work, and stop for the warning signs above. People with long-term conditions may wish to ask their specialist before starting. With uncontrolled high blood pressure, avoid straining against a held breath; the high blood pressure guide has more.
See your GP first if you get chest pain, breathlessness or dizziness when you are active, if you have a heart condition and want to exercise harder, or if you have had a fall.
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You feel any pain or become unwell, as the NHS advises for its Pilates videos, and especially for chest pain or pressure, unusual breathlessness, dizziness or fainting. If you have a health problem, an injury or any symptoms, get advice from a healthcare professional, such as a GP, before you start.
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The NHS advises getting advice from a healthcare professional first if you have a health problem, an injury or symptoms, or have recently had a heart attack or an operation.
If you have a heart, lung or joint condition, are pregnant or have recently been unwell, start gently and read our guide for your condition. Muscle soreness for a day or two after a new exercise is common and fades as you repeat it.
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No move takes fat off one place, in 13 controlled studies, and in Pilates trials the waist didn't change significantly. Part of your waist is your ribs and pelvis. What Pilates gives is a stronger trunk; the waist changes, if it does, with the rest of you.
Ab exercises 5 days a week for 6 weeks changed neither the waist nor the fat above the hip bone. The idea that the obliques need targeting to burn waist fat is spot reduction, which the trials don't support.
No trial has measured the waist after the garment comes off, the one randomised corset trial couldn't be judged because only 20% kept wearing it, tight compression made reflux about 8 times more common in a small study, and serious harm is rare but reported.
No study has measured it. The muscle changes measured after Pilates are small (8% of oblique volume on one side after 36 weeks), while the waist moves by centimetres with whole-body activity, so visible widening from ordinary Pilates is very unlikely (our reading).
The deep tummy muscle works harder during Pilates moves, but its thickness at rest didn't change in a pilot trial, and drawing in narrows the tape only while you hold it.
Not shown: the reviews found few studies, mostly at high risk of bias, and couldn't recommend hypopressive exercise.
The reformer trial in women with overweight measured weight and a bioimpedance scale, not the waist, and the reviews found no significant waist change from Pilates of any kind. Reformer classes are good strength work.
Pilates builds trunk strength and endurance and counts as muscle-strengthening activity. Waist and weight can change separately, and part of the waist won't change at all. Judge by months, by what you can do, and by how you feel.
Not from one spot: no exercise takes fat off the part of the body it works. In Pilates trials the waist changed by a few centimetres at most, not significantly in the reviews, and about as much as with walking. A waist gets smaller, if it does, with the rest of you, through moving more and eating a little less.
For the muscles of the waist: the criss-cross, side planks and the side bend for the obliques, the saw and spine twist for turning, and the dead bug and hundred for the deep tummy muscle. They make your trunk stronger; they don't burn the fat over it. For the waist measurement itself, brisk walking or other aerobic activity does the most.
Very unlikely: the side muscles grow only a little with Pilates, about 8% on one side after 9 months in one small scan study, and no study has found a wider waist from side bends. If your waist reads bigger, check you measured the same way, relaxed and breathing out, and think of bloating or weight gain first.
In trials of brisk activity, the waist fell by about 3 cm over a few months, and by about 4 cm more than in people who didn't exercise after 24 weeks of regular exercise. Pilates on its own changed it less reliably. Judge by months, not days; nothing safe works in a week.
Yes: in a lab study the criss-cross gave the highest trunk-muscle activity of the Pilates moves tested, and the saw, spine twist and side bend are taught for the obliques. Side planks worked them hard too.
Neither has been shown to shrink it: the reformer trial in women with overweight didn't measure the waist, and no wall Pilates trial has. Choose the one you'll keep doing, and add brisk activity for the waist.
No: no trial shows a waist trainer gives a lasting smaller waist, tight compression can make reflux worse, and it stops your trunk muscles doing the work. Take one off and don't wear it again if it brings on reflux, breathing trouble, swollen legs or sore skin.
Drawing in narrows the tape only while you hold it. Reviews of hypopressive exercise found low-quality studies and couldn't recommend it. The deep tummy muscle works during Pilates moves, not as a permanent corset.
It can't change the bones of your ribs and pelvis or where your body stores fat. It can make the muscles of your trunk, hips and shoulders stronger. Bodies come in many shapes, and no exercise promises one.
Find your lowest rib and the top of your hip bone, wrap the tape midway between them (just above the belly button), and breathe out naturally before you read it, as NICE says. Don't hold your tummy in: the Pilates stance can read up to 5 cm smaller. Measure the same way each time.
NICE suggests keeping your waist to less than half your height: a ratio of 0.5 to 0.59 means increased health risk and 0.6 or more further increased. It's a guide to health, not a judgement of your body. The NHS calculator isn't for use in pregnancy or with an eating disorder.
Probably not: Pilates is light work, and what moved the waist in trials was 150 minutes a week or more of brisk activity, with eating a little less. Pilates still earns its place as your strength work twice a week.
Exercise education, not a personal prescription, and clinical review of these guides is pending. If you are pregnant, have a health condition or have had recent surgery, check with a doctor, midwife or physiotherapist before starting, and stop for sharp or increasing pain. Health disclaimer.
