A 49 inch waist definitely isn't a healthy waist size for anyone. Scientists have known for decades now that having an excessively big stomach—usually above 37 inches for men and 35 inches for women—increases your risk of chronic illnesses like heart disease and diabetes.
But it's not all doom and gloom. You can lose a significant amount of stomach size by making some simple lifestyle changes. For example, there are plenty of healthy, low-calorie foods that actually taste great and make you feel fuller (and more nourished) than junk food.
By the same token, there are countless types of exercise that you can do. If you want to socialize and make some new fitness friends, then you can go to gym classes. If you're a bit more self-conscious and want more privacy, then you can challenge yourself with a fat-blasting workout at home.
Why is it bad to have a 49 inch waist?
BMI is commonly used to determine the health status of an individual. However, by not taking into account your waist size, you're missing a trick. This is because research shows that your waist circumference can predict your risk of obesity-related cardiometabolic disease (stroke, heart attack, diabetes, etc.) 
So, from a physical health standpoint, it's undesirable to have a 49 inch waist because it's well above the cut-off points for being considered low risk of various chronic diseases.
From a personal perspective, you can certainly have a positive view of your body while having excess stomach fat. Having a good attitude towards your own physique may well help you to stay on track when you have cravings for foods or feel like skipping a workout.
Still, even with all of the positivity in the world, you just cannot enjoy peak health while maintaining a 49 in waist because such a stomach size can lead to countless long-term health problems, some of which I noted above.
Ideally, you should keep your waist size to less than half of your height. Or, to say it another way, your waist-to-height ratio (WHR) should be less than 0.5.  So at 49 inches, it's unlikely that you have a healthy WHR unless you're exceptionally tall.
What causes a person to have a 49 inch waist?
We're all built differently, and some of us naturally have a harder time shedding stomach fat than others. This can be frustrating because it makes you feel like you're fighting against the will of your own body.
Of course, it's unlikely that you have a 49″ waist purely due to your genetics. Indeed, overfeeding and a lack of exercise are the more common and realistic causes of someone having a 49 inch waistline.
Certain types of foods, which is to say junk food, can be highly addictive and cause you to continue eating even when your body already has plenty of fuel.
That's why cooking delicious meals (there's so much inspiration in cookbooks and online) can be such a potent weapon against food cravings. If you can make healthy foods taste good, then there's simply no need for junk foods that are devoid of nutrition!
How can you reduce your 49 in waist?
We know that weight loss boils down to putting your body in an energy deficit. Usually, this means eating fewer calories than your body needs to maintain its weight, and that indeed is an excellent way to shed the pounds.
And yet, many dieters overlook the importance of exercise.  Remember, we're trying to create an energy deficit here. You can do that by decreasing your calories, but if you keep on reducing your food intake in a bid to lose more weight, things can quickly become unsustainable—especially over the mid and long term.
Understand that exercise does help you to create an energy deficit. In theory, you could keep your calories where they are now and simply create the necessary energy deficit for weight loss by performing exercise.
This is obviously another extreme, and most people are definitely best off creating an energy deficit through a combination of strength training, cardiovascular exercise, and moderate calorie restriction. This way, your life will naturally feel more balanced, and you won't feel as resentful to your diet or exercise routine.
Just because you have a 49 inch waist now doesn't mean that you need to have one a few months down the road.
While you should aim for moderate and sustainable weight loss, don't be surprised if you shed extra pounds in the initial weeks of your journey. Much of this initial weight will be water weight, the loss of which can result in immediate reductions in waist circumference.
There are many people who had a 49″ waist (or a much larger waistline) and then transformed their bodies and improved their health. So while there's no need for you to have a particular type of physique, you should know that it's definitely possible to slim your 49 in stomach in a safe and effective manner.
- Howard, W. (2008). Waist Circumference and Cardiometabolic Risk: A Consensus Statement from Shaping America’s Health: Association for Weight Management and Obesity Prevention; NAASO, The Obesity Society; the American Society for Nutrition; and the American Diabetes Association. Yearbook of Endocrinology, 2008, 91–92. https://doi.org/10.1016/s0084-3741(08)79122-4
- Ashwell, M., & Gibson, S. (2016). Waist-to-height ratio as an indicator of ‘early health risk’: simpler and more predictive than using a ‘matrix’ based on BMI and waist circumference. BMJ Open, 6(3), e010159. https://doi.org/10.1136/bmjopen-2015-010159
- Prologo, D. (2018, November 4). Yes exercise really does play a role in weight loss. Washington Post. https://www.washingtonpost.com/national/health-science/yes-exercise-really-does-play-a-role-in-weight-loss/2018/11/02/a4ece100-d63a-11e8-aeb7-ddcad4a0a54e_story.html