When Being Normal Weight is Unhealthy

When Being Normal Weight is Unhealthy

(Last Updated On: March 26, 2019)

When Being Normal Weight is Unhealthy

When you step on the scale and see you’re within your ideal weight range, based on the charts, you’re pretty happy, right? Unfortunately, the weight the scale spits back at you only tells part of the story. It’s a measure of the weight of everything in and on your body – your bones, muscles, internal organs, any excess fluid you have in your body, and, of course, body fat. It tells you nothing about your body fat percentage unless you have a special scale that uses bioelectrical impedance that measures body fat and these aren’t highly accurate.

Another measure doctors use to determine whether a patient is overweight or obese is BMI or body mass index. You can calculate your BMI using an online calculator, and the value is a comparison of your weight to your height. Regrettably, neither BMI or body weight say anything about your health or even your body composition, yet these are the values doctors use to decide whether you need to lose weight.

As a new study shows, you can be of normal weight and still be unhealthy. As researchers at the Institute of Cardiology at Laval University in Quebec, Canada found, if you carry excess fat around your belly, you’re at higher risk for health problems irrespective of your weight. You’ve probably heard the expression “skinny fat,” used to describe people with a normal or sub-normal weight and a high percentage of body fat. Another term for this condition is normal-weight obesity.

How common is normal weight obesity?

Why is normal-weight obesity a problem?  A study published in the American Journal of Cardiology in 2013 found that people of normal weight with high levels of body fat are at greater risk of heart disease. Other studies show having a high level of body fat, irrespective of weight, is linked with a greater risk for metabolic problems, like metabolic syndrome and type 2 diabetes.

The new study mentioned above points out the health risks of having excess belly fat if your weight is normal. When researchers followed men of ideal body weight with extra fat around their waist and belly, they had double the risk of dying compared to those who didn’t have a pouch of fat around their waist or belly. Women weren’t exempt either. Women of normal weight with excess belly fat were at a 32% higher risk of death.

When fat builds up around your waistline, it’s often a sign of a deeper problem – visceral fat, a particularly harmful type of fat that lies deep in your pelvic cavity. Visceral fat is tied to health problems like insulin resistance and chronic inflammation, conditions tied to type 2 diabetes and heart disease, among other health problems.

As Dr. Mark Hyman, director of the Cleveland Clinic Center for Functional Medicine, points out: skinny-fat folks, despite looking lean on the outside, often have “hidden” problems like an abnormal lipid profile, insulin resistance, too little muscle mass, and inflammation. Although superficially they look healthy, all is not as it should be “under the hood.”

With age, an even more serious version of skinny fat called sarcopenia develops where body fat percentage increases as muscle mass and strength decline. Shockingly, around 45% of older people suffer from this condition. Sarcopenia is more than a cosmetic issue, it’s a condition that affects your balance, how you walk, and your ability to carry out everyday activities. There’s no single cause for sarcopenia, although one of the most important factors is a lack of physical activity, specifically resistance training. Nutritional imbalances, especially inadequate protein, and declining hormone levels are other factors.

The Best Treatment for the Skinny-Fat Syndrome and Sarcopenia

Fortunately, there is help for people with both of these conditions. The best way to treat sarcopenia, skinny fat, and excess belly fat is through high-intensity resistance training. Placing stress on muscles causes the muscle fibers to grow in size and the muscles to become stronger. High-intensity resistance training also helps you shed body fat, including stubborn belly fat. In addition, resistance training makes cells more sensitive to insulin, thereby reducing insulin resistance and the threat of type 2 diabetes.

What about nutrition for averting sarcopenia? According to recent research, men and women may benefit from more dietary protein as they age, and if you’re resistance training you may need up to twice the recommended amount of protein (0.8 grams per kilogram of body weight daily), although how much you need will depend on how intensely you’re training.

Another nutritional concern is how much vitamin D you’re taking in. One of the classic signs of vitamin D is muscle weakness and fatigue. Research shows in people who are deficient, taking a vitamin D supplement improves muscle strength. What’s not clear is whether supplemental vitamin D has benefits in people who already have a normal vitamin level. At the very least, get your vitamin D level checked. Risk factors for vitamin D deficiency include:

.   Living in an area that gets little direct sunlight

.   Having darkly pigmented skin

.   Getting little sun exposure

.   Being over the age of 60

.   Being overweight or obese


The Bottom Line

Don’t read too much into the number you see on the scale. If you’re carrying a high percentage of body fat, have a large waist size, or have obvious belly fat, you’re at higher risk for health problems. Time to focus on resistance training and switch to a whole food diet with adequate protein. It’s not just your weight that matters – it’s your body composition too.



MedicineNet.com. “Belly Fat is Bad, Even at a Normal Weight” November 9, 2015.

Int J Vitam Nutr Res. 2011 Mar;81(2-3):109-19. doi: 10.1024/0300-9831/a000061.

Time Magazine. “The Hidden Dangers of Skinny Fat”

International Osteoporosis Foundation. “What is Sarcopenia?”

Medscape Multi-Specialty. “Resistance Training Benefits Type 2 Diabetics”

Purdue University. “Elderly women may benefit from higher amounts of protein”

Today’s Dietitian. Vol. 14 No. 9 P. 62. September 2012.

Harvard School of Public Health. “Low Vitamin D: What Increases The Risk?”

Arch Intern Med. 2009 Mar 23;169(6):626-32. doi: 10.1001/archinternmed.2008.604.


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