Do you consider yourself healthy because you’re skinny? Well, with the rise of “skinny fat”, you may want to think again…

As researchers are discovering, “skinny” does not necessarily mean “healthy and fit”. In fact, it could mean quite the opposite and place you at an elevated risk for chronic diseases and death. Colloquially, this new health concern is being referred to as “skinny fat”, and it’s a growing problem here in the United States according to doctors and health researchers.

What Is “Skinny Fat”?

“Skinny Fat”, or normal-weight obesity, refers to individuals who do not appear to be overweight, but still have a high percentage of fatty tissue compared to lean tissue. The body mass index (or BMI) is a ratio of weight and height and is how a healthy weight has been typically calculated in the past. Individuals who are “skinny fat” fall within the normal limits of the body mass index, but still have a high percentage of body fat. Often, this fat is visceral fat, which is fat stored within the abdominal cavity and surrounds a number of vital organs.

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Why Is There Cause To Be Concerned?

Until recently, the focus of scientific research has been on how increased body weight can lead to a greater risk of disease with little emphasis on body composition, or the ratio of fat to lean body mass. But now, new research is showing that body composition is more important than simple body weight when analyzing the health of individuals.

A recent study analyzed the relationship between body fat percentage and cardiorespiratory fitness (or CRF), which is a strong predictor of cardiovascular disease and premature death. The findings of the study showed that body fat percentage was inversely related to cardiorespiratory fitness. In other words, participants in the study with larger amounts of body fat were found to be less fit, independent of their body weight or stature.

As lead author of another new study on belly fat, Mayo Clinic cardiologist Francisco Lopez-Jimenez, says, “Not all fat is equal.” Comprised of more than 15,000 participants, the 14-year study found normal weight men with big bellies were twice as likely to die compared to obese men. Normal weight women with big bellies were 32% more likely to die compared to obese women. Belly fat appears to be especially dangerous because it’s often deposited in the liver, where it makes inflammatory substances that contribute to diabetes and heart disease. This was the first study to show that those who are “skinny fat” appear to be at a greater risk than those with obesity.

At this point, there’s not a consensus among the scientific community about what causes “skinny fat”, although it is believed to be a combination of genes and enviornmental factors.

What Should Be Done…

First of all, we have to eliminate the notion of unquestionably associating “skinny” with “healthy”. If we don’t, we will continue to put normal-weight individuals at a greater risk because they will continue to be misclassified as automatically being healthy when they may actually be at a high risk for chronic diseases and not treated or attended to properly.

Second, to check whether you may be “skinny fat”, calculate your waist-to-hip ratio. To do so, first determine your waist circumference by measuring the distance around the smallest area of your waist, usually just above the belly button. Then, determine your hip circumference by measuring the distance around the largest area of your hips, usually the widest part of the buttocks. Once you have your waist and hip measurements, divide your waist measurement by your hip measurement. For example, divide a waist circumference of 34 inches by a hip circumference of 38 inches to yield a waist-to-hip ratio of .89. For men, a ratio of .90 or less is considered safe. For women, a ratio of .80 or less is considered safe.

If your waist-to-hip ratio is above what is considered safe, you may be at risk for heart disease and other health conditions associated with being overweight. You should consider whether you’re exercising enough and eating a healthy diet. You may also want to check in with your doctor to ensure an underlying health problem is not going untreated. Ultimately though, the way to combat “skinny fat” is through exercise and nutrition.

As Dr. Keith Bachman, a weight-management specialist with Kaiser Permanente’s Care Management Institute, emphasizes, “Good health is more than a BMI or a number on a scale. We know that people who choose a healthy lifestyle enjoy better health.” Dr. Bachman suggests a balanced diet, physical activity, and stress management as healthy lifestyle practices.

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