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Our review included 32 studies. To detect obesity with body mass index (BMI), the meta-analyses rendered a sensitivity of 51.4% (95% CI 38.5\u201364.2%) and a specificity of 95.4% (95% CI 90.7\u201397.8%) in women, and 49.6% (95% CI 34.8\u201364.5%) and 97.3% (95% CI 92.1\u201399.1%), respectively, in men. For waist circumference (WC), the summary estimates for the sensitivity were 62.4% (95% CI 49.2\u201373.9%) and 88.1% for the specificity (95% CI 77.0\u201394.2%) in men, and 57.0% (95% CI 32.2\u201379.0%) and 94.8% (95% CI 85.8\u201398.2%), respectively, in women. The data were insufficient to pool the results for waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) but were similar to BMI and WC. In conclusion, BMI and WC have serious limitations for use as obesity screening tools in clinical practice despite their widespread use. No evidence supports that WHR and WHtR are more suitable than BMI or WC to assess body fat. 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