Why being 'skinny fat' is dangerous for your health and how to fix it

• Skinny fat describes those with a normal BMI, high body fat percentage, and poor metabolic health.
• Being "skinny fat" increases your risk of type 2 diabetes, heart disease, and high cholesterol.
• To go from "skinny fat" to fit, exercise, eat a healthy diet and do some form of strength training.

When it comes to being healthy, your weight isn't the only factor.

Case in point, there are plenty of people out there who are of normal weight but still at risk of certain health conditions like heart disease. The colloquial term for this is "skinny fat" and in the medical realm it's referred to as "normal weight, metabolically unhealthy."

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"Skinny fat", although not the most body-positive phrase, refers to a condition in which a person has a body weight, or body mass index (BMI), in the normal range but has a relatively high body fat percentage, says Glenn Gaesser, PhD, a professor of exercise physiology Arizona State University who conducts research on how diet and exercise affect cardiovascular health.

Here's how to tell if you're "skinny fat" and, if so, how to improve your overall health.

What is "skinny fat"?

Those who are skinny fat have what is called poor metabolic health.

Poor metabolic health means your blood pressure and cholesterol levels are high, which can increase the risk of heart disease. Only 12% of Americans are considered metabolically healthy.

5 measurements of metabolic health

• Triglyceride levels. Triglycerides are a type of fat found in the blood. A normal range for triglycerides is less than 150 milligrams per deciliter (mg/dL).
• High-density lipoprotein (HDL) levels, which is the "good" kind of cholesterol. A healthy range of HDL levels is 60 milligrams per deciliter (mg/dL) or higher.
• Blood pressure, which refers to the pressure in your arteries. A normal blood pressure level is less than 120/80 mmHg.
• High blood sugar: When blood sugar is higher than 130 mg/dL after not eating or drinking for eight hours.
• Excess abdominal fat

It can be hard to know whether or not someone is metabolically unhealthy by their appearance alone, and there isn't a universally agreed-upon definition or set of criteria, Gaesser says. However, there are behaviors and lifestyle choices that can increase your risk of becoming "skinny fat", including:

• Lack of exercise. A sedentary lifestyle increases your risk of low muscle mass and high amounts of fat, Gaesser says. Older people are also more at risk of poor metabolic health because we lose muscle mass as we age.
• Poor diet. Eating processed foods and a diet lacking in whole grains, vegetables, fruits, and lean protein, can increase low-density lipoprotein (LDL) cholesterol. This is the "bad" kind of cholesterol that increases your risk of heart disease.

If you suspect you may have poor metabolic health, despite being a "healthy" weight, talk with your doctor, says Krissy Maurin, MS, head wellness coordinator at Providence St. Joseph Hospital. Having blood work done to measure cholesterol and blood sugar levels can help determine if you are at risk.

Health consequences of being "skinny fat"

The health consequences of being "skinny fat" are similar to those affiliated with obesity, and include:

• Increased risk of developing type 2 diabetes
• High cholesterol levels, which can increase the risk of heart disease
• High blood pressure

Important: According to a 2017 paper, people who are of normal weight but metabolically unhealthy have three times the risk of heart disease compared to people who are of normal weight and metabolically healthy.

People who fall within a healthy weight range can still have too much fat on their bodies, and if that fat is carried around the belly area, it can increase the risk of disease. Research shows the risk of health complications is greater if large amounts of body fat are visceral, which is fat carried around the belly area. Visceral fat has been associated with many diseases, like heart disease, and even early death, Maurin says.

In fact, a 2018 study found women who carried weight primarily in the middle of their bodies had a 10% to 20% greater risk of heart attack than women who were heavier overall.

How to go from "skinny fat" to fit

• Strength train. Any kind of weight-bearing exercise will improve your metabolic health, Maurin says. This can include yoga, pilates, lifting weights, or doing bodyweight exercises like pushups. Aim for two to three resistance training workouts per week, says Maurin.
• Eat less processed food and more whole foods. Fiber-rich foods in particular, like vegetables, legumes, whole grains, and fruits can improve metabolic health.
• Do aerobic exercises. Continuous aerobic exercise of 30 to 40 minutes or high-intensity interval training (HIIT) are both effective at improving metabolic health and reducing visceral fat, even in the absence of significant weight loss, Gaesser says.

Insider's takeaway

"Skinny fat" refers to a condition in which a person has a normal weight, but a high body fat percentage, which can increase your risk of disease. If you think this may apply to you, talk to your doctor. You can improve your metabolic health by increasing physical activity and eating less processed foods.

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