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From fashion models to fitness magazines, the message that “skinnier is better” has permeated our culture so much by now that the more crucial message of how actually to be healthy has gotten washed out.

The result? Millions of people are what’s affectionately referred to as “skinny fat,” which happens when a person is a normal weight or perhaps even underweight but has a dangerously high percentage of body fat compared to lean muscle mass.

Their unhealthy lifestyle puts them at risk for issues like cardiovascular disease, stroke, diabetes, and more—the same problems that we tend to associate solely with obese people or those suffering from metabolic syndrome.

The skinny fat epidemic is an important reminder that being thin does not necessarily make you healthy, and being a little larger does not necessarily make you unhealthy. Read on to learn how to identify if you’re skinny fat, the dangers of being skinny fat, and what to do about it.

What Is “Skinny Fat?”

We all have that friend—or maybe it’s you—who’s usually able to eat whatever they want without gaining too much weight. Because they don’t put on too much weight, they rarely exercise and consider cardio and strength training completely unnecessary. In turn, they end up staying thin on the outside but relatively weak, with a higher amount of body fat compared to lean muscle. They make look fine on the outside, but their high percentage of body fat is concerning. Skinny fat is a term used to describe this phenomenon.

What’s more, as you get older, you lose muscle more easily; in fact, you can lose up to  5% of your muscle mass per decade after the age of 30 if you’re not actively replacing it. So when your muscle tissue starts to deteriorate but your body fat stays the same, you now have an even unhealthier ratio of fat to muscle. Many women in their 40s, 50s, and 60s can have a high percentage of body fat but look great in their clothes. But don’t be fooled: this can lead to a whole set of issues like heart disease, low bone density, and more.

What Causes Skinny Fat?

As I’ve alluded to above, being skinny fat comes from your body composition being imbalanced. Your body composition refers to the proportion of muscle to fat. A certain amount of body fat is necessary for insulation and thermoregulation, hormone production, and to cushion your vital organs. But too much body fat is detrimental to your health, no matter how it shows up. If you’re naturally thin but don’t ever build muscle, you’ll still have a higher percentage of body fat to lean muscle—even if you don’t look large. Let that sink in for a second: No matter your weight, if you have an imbalanced ratio of fat to muscle, you’re at an increased risk for cardiovascular disease, stroke, and other health issues.

Another thing to mention here is the misconception that all fat is created equally. It’s not! There are two main types of fat: subcutaneous and visceral. Subcutaneous fat is just beneath your skin—you can grab it with your hands. Visceral fat, on the other hand, is much more dangerous—it’s fat that lives around your organs and within your abdominal cavity, often showing up as excess belly fat. Dr. Mark Hyman, the author of The Blood Sugar Solution 10-Day Detox Diet, notes that “when you eat a diet high in sugar and processed foods, it directly causes visceral fat storage.” This explains why you may appear thin or a normal size but actually have a lot of visceral fat because of poor dietary choices or an inactive, sedentary lifestyle. And while this fat isn’t always visible to the naked eye, it’s actually more dangerous.

The Dangers of Being Skinny Fat

thin woman looking at camera

The medical term for ‘skinny fat’ is technically MONW or “metabolically obese, normal weight.” People who are skinny fat are often a normal weight (or underweight!), but because of their inactivity, lack of muscle, or poor diet, they have a high percentage of body fat. Often, other crucial health numbers tend to be elevated, too. If you’re skinny fat you may also have:

  • High blood sugar leads to insulin resistance or diabetes.
  • High levels of inflammation in the body which is linked to an increased risk of certain cancers, heart disease, arthritis, psoriasis, and depression.
  • Elevated blood pressure puts you at increased risk of stroke and dementia.
  • High triglycerides can cause heart disease.
  • Vitamin deficiencies can contribute to conditions such as chronic fatigue, anemia, and more
  • Digestive issues like IBS or acid reflux

How Do You Know If You’re Skinny Fat?

None of that sounds fun, right? But it all could be lurking beneath the surface of an outwardly thin appearance. Below are some telltale signs that you could be skinny fat; if you identify with a few or all of them, make an appointment with your doctor to get your numbers checked.

  • You feel dizzy or light-headed after mild exercise
  • You don’t lift weights or do any kind of strength training and haven’t for many years
  • You have excess belly fat
  • Your diet is high on carbs, sugar, and processed foods and low on protein
  • You’re menopausal and post-menopausal and don’t do any strength training because your weight isn’t an issue
  • You have “sugar crashes” and experience a lot of fatigue and problems concentrating or focusing

How Can You Measure Body Fat?

While tests for cholesterol, blood sugar, and blood pressure are readily available at most doctor’s offices, you also want to ask your doctor for a way to measure your body fat. Finding out this number will be an important indicator if you truly do qualify as “skinny fat” by having a high percentage of body fat (What’s considered high? Anything over 31% is considered dangerous.) There are a few different methods out there, but here are a few I would recommend for measuring your body fat:

  1. Bioelectrical Impedance (BIA) measures electrical signals as they pass through fat, lean mass, and water in the body. If you’re using one of these machines in a health lab or fitness setting, I’d have good faith in the results.
  2. DEXA scans (usually found in clinical settings), are among the most accurate methods. It’s a whole body scan that delivers a low dose x-ray that reads bone and soft tissue mass and can identify regional body fat distribution as well.
  3. Air Displacement Method or “BOD POD” is an egg-shaped chamber that measures the amount of air displaced when a person sits in the machine. By using the air displacement and your current weight, it can give you a very accurate reading.

What Can You Do About Skinny Fat?

If you’re officially a part of the skinny fat club, what can you do about it? The good news is, your health is in your hands!

It’s up to you to make a few lifestyle changes to go from skinny fat to strong, healthy, and balanced. Do these three things to start transforming skinny fat into healthy.

1. Exercise Often (Including Strength Training!)

If you’re skinny fat, you need to switch from an inactive lifestyle to one that includes both cardiovascular exercise and strength training. Building muscle is crucial to reversing the negative health effects of being skinny fat, so please don’t skip the strength!! Strength training can be done with weights or with your own body weight alone; there’s no fancy equipment required.

Check out our Beginner’s Guide to Strength Training to learn how to get started.

Aim for the CDC’s recommended 150 minutes of cardiovascular activity for a week, and start strength training 2-3 times per week.

Putting on muscle will re-balance your body composition, making you healthy and strong.

2. Edit Your Food Choices

heart healthy diet

Don’t think you have to “diet” or cut back calories if you’re skinny fat; on the contrary, you need to be sure you’re eating healthy, whole foods that nourish your body and muscles.

Make sure you’re eating a plant-heavy diet (it’s time to make friends with green things that come from the earth!) and include clean sources of protein (like lean chicken breast, salmon, and occasionally red meat) as well as healthy fats (olive oil, avocados, nuts) and fruits, legumes, and whole grains.

3. Manage Stress

Stress management also plays a role in whole-body health. Studies show that chronic stress makes your body cling onto visceral fat (the bad kind, remember?) Make meditation a daily practice, take time to unplug from devices, try yoga, and practice deep breathing when faced with difficult situations.

The Takeaway: Health Is More Than Your Weight

The most important thing to remember is that your health is more internal than external. Of course, being obese or overweight puts you at risk for many health problems, but don’t think that just because you’re not overweight, you’re automatically exempt from those dangers. What you feed your body and how you move your body are two of the most important factors in your health. And yes, genetics can play a role. So take charge of your health and get all your numbers checked, not just your weight. The important numbers to know for your health are your body composition (the ratio of muscle to fat), your blood pressure, your blood sugar, and your cholesterol (including the “good cholesterol,” the “bad cholesterol,” and your triglycerides). Getting these numbers in the normal range is so much more important than any number on the scale.

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