Weight and BMI (body mass index) have been the common standards for evaluating an individual’s health for years, decades even. And yet, they don’t really tell the whole story. Think of that skinny person who eats terribly and never exercises yet doesn’t seem to gain a pound. Or, look at the extremely athletic person who has a weight and BMI to indicate obesity despite having greater muscle mass to account for that extra weight.
Muscle and fat are quite different. And the number on the scale doesn’t always reflect that.
What it is
“Skinny fat” – also termed “metabolically obese” among medical professionals refers to someone who has a normal weight and BMI but with increased visceral fat (abdominal fat) and other abnormal metabolic markers including high cholesterol, high blood pressure, diabetes, etc. It can also refer to someone who severely restricts calories and as a result has less lean body mass and therefore more visceral fat. The exact definition varies but essentially it boils down to someone who appears thin on the outside but has metabolic problems commonly associated with someone who is overweight/obese.
“Fat & fit” – also termed “metabolically healthy obese” is essentially the opposite of ‘skinny fat’. This is someone with a weight and BMI indicating obesity but with a normal healthy metabolic profile (i.e. cholesterol, blood pressure, blood sugar, etc.). This definition also varies but is basically someone who appears obese physically but has no adverse metabolic problems currently.
The term “skinny fat” has had a negative connotation. It implies that just because you are thin does not mean that you are healthy. And “fat & fit” has been perceived more positively, with the view that you may still be healthy regardless of carrying around excess weight.
But what is really going on? Weight is what so many of us use to judge a person’s health– be it by ourselves, others, or even medical professionals. The truth is, we’re finding out more and more that the actual weight of an individual may not carry as much weight as we thought (pun intended).
Much of the research shows that when an individual has abnormal metabolic profiles, regardless of weight, they are at increased risk for many diseases, including heart disease, diabetes, hypertension, among others. Clearly then, those persons who fall into the ‘skinny fat’ category are at increased risk. of developing these issues. That said, we once thought that ‘fat and fit’ individuals were better off. Recently, several studies have shown that even with normal metabolic profiles, overweight and obese persons are still at increased risk of the same diseases as “unhealthy obese” (obese individuals with abnormal blood work), though perhaps not to the same extent. The thought is that these persons are at greater risk of eventually having these issues in the future, more so than a healthy individual who is of normal weight.
What does it all mean?
It’s clear that eating right and being physically active are the most important when it comes to overall health and reducing risk of many common diseases. Personally, I think it is best that we shift the focus away from weight and emphasize this very point – good nutrition and exercise is key. Unlike we’ve been led to believe by so many, personal appearance does not indicate health status.