Hidden Health Risks of Being 'Skinny Fat'

The scale says 125 pounds. And when you gaze at the mirror you see a svelte 5-foot, 6-inch woman.

How could you possibly be thin and at risk for a host of health ailments?

Known in doctor speak as metabolically obese normal weight (MONW) – or more commonly “skinny fat” – it’s one of the fastest growing medical conditions. In a 2012 study, researchers found that about 1 in 4 skinny people had pre-diabetes and were classified as being medically obese.

Regardless of the term used, it means someone who is in their ideal weight range but has more body fat than is healthy.

So while these people are slim, they are not necessarily fit or follow a healthy lifestyle, says a New York endocrinologist.

Excess body fat – especially visceral fat which surrounds organs – can cause metabolic syndrome, a cluster of conditions, such as high blood pressure and high blood sugar, which increases the chance of heart disease, diabetes, or stroke.

“The bottom line is that weight is not always a predictor of metabolic syndrome,” says Alyson Myers, MD, Medical Director of inpatient diabetes at North Shore University Hospital.

Neither is BMI. The well-known ratio of weight to height arrives at a measure of body fat that can’t distinguish between a person’s body fat and lean body mass.

“So a bodybuilder could have a have an elevated BMI of 28 or 29 but really only have minimal body fat,” says Dr. Myers.

A better gauge of how much body fat a person has is to do a DXA scan, she said. The scan uses two low-level X-ray beams to assess the amount of fat, where it’s stored in the body and bone mineral density.

However, the scan is not part of a routine medical exam.

“Typically this is only during osteoporosis screening,” said Dr. Myers. “The only time you would see it be using to screen for body fat is if it’s being done for research.”

Exercise and diet are key to preventing the health risks associated with MONW.

“The best way to treat skinny fat is to carry-out an exercise regimen with aerobic exercise and resistance training to convert the excess body fat to lean muscle,” said Dr. Myers.

Also, remember that all carbs are not the same, she added.

Avoid a diet high in high-glycemic foods or white-based carbohydrates (i.e., potatoes, white bread, and white rice) and choose lower-glycemic fruits like apples, oranges, berries and cherries.