Just when you thought you knew what obese looked like, an army of skinny-fat people come marching along with little pot bellies hidden under their pear-shaped shirts. No, we’re not on the cusp of a diet-war, but diabetes and heart disease are waging a silent attack on people with normal weight obesity, also known as “skinny-fat.”
While the term normal weight obesity sounds as absurd as fat-free Twinkie, it’s a new and legitimate condition that, according to the Mayo Clinic, may afflict up to 30 million Americans.
In medical terms, normal weight obesity is typified by a normal Body Mass Index (BMI), usually 18.5-24.9, with a large percentage of body fat. In layman’s terms, people with normal weight obesity appear to be thin and healthy, but have large concentrations of central obesity—pooch bellies—and stores of fat around vital organs.
Led by Dr. Karine Sahakyan, The Mayo Clinic conducted a nearly 15-year study of 12,785 subjects, specifically geared toward determining the significance of central obesity. The doctors used a fun, new scientific measurement called “waist-to-hip ratio”—muffin top to where God intended your jeans to sit—as a means to statistically legitimize belly fat. They found that subjects with a normal BMI and a high waist-to-hip ratio—skinny-fat people—”had the highest cardiovascular death risk and the highest death risk…” out of all other demographics studied.
Dr. Sahakyan was alarmed: “This group has the highest death rate, even higher than those who are considered obese based on BMI. From a public health perspective, this is a significant finding.”
In a similar study conducted by The American Journal of Clinical Nutrition, doctors found a high risk of metabolic syndrome—risk factors like coronary artery disease, stroke, and type 2 diabetes—in women with normal weight obesity. What may be more alarming to people with a normal BMI is that those with a BMI characterized as being overweight (BMI 25.0-29.9) had a lower mortality rate than their skinny-fat peers.
The JAMA Network analyzed 100 studies of of nearly three million adults, and according to Steven B. Heymsfield, M.D., “The optimal BMI linked with lowest mortality…may be within the overweight and obesity range. Even in the absence of chronic disease, small excess amounts of adipose tissue may provide needed energy reserves during acute catabolic illnesses…”.
Overweight individuals are healthier than skinny-fat individuals? Jury’s still out, but there are several courses of corrective action to pursue if you feel you are at risk of being normal weight obese. There are a number of “green” diets full of whole foods and devoid of processed foods that, when paired with exercise, can help your body function properly and crack down on your “wasit-to-hip ratio.”
Identifying yourself as healthy is not as simple as an eyeball test. Even if you think you look and feel good, it’s important to determine your BMI so you can protect yourself from disease, decay, and the skinny-fat doldrums.