The Skinny on Skinny Fat: What is Normal Weight Obesity?

Written by Tim Skwiat

What is Skinny Fat?

Have you ever sat next to someone who was skinny, yet looked like she or he had no real muscle tone? Maybe even looked a little flabby or had a bit of a belly, despite her or his average weight and a fairly trim appearance?

Is that person the one looking back at you in the mirror? If so, this may be one of the most important articles you can read.

You might be asking, “Is it even possible to be skinny and fat at the same time?” Yes, indeed. And there’s even a name for it: “skinny fat.”

According to researchers, skinny fat is defined as “metabolically obese normal weight” or “normal weight obesity.”1 But what does that mean?!

Typically, this means carrying an excessive amount of body fat (especially belly fat) along with too little muscle mass. Along these lines, it’s possible—quite possible, in fact—that you may be “normal” weight yet have worse metabolic health (and greater risk for disease and death) than someone who’s overweight or even obese.

You see, there’s a common misconception that body weight is a reliable and accurate depiction of health. However, the number on a scale says very little about how fit you are, how much body fat you carry, your fat storage patterns, how much muscle you have, or even your risk of health issues.

What is Normal Weight

What Is Skinny Fat and “Normal” Weight Obesity?

Typically, “ideal” or “normal” weight is calculated as a ratio of body weight to height. The most commonly used tool is called the Body Mass Index (BMI). This is a person’s weight (in kilograms) divided by his/her height (in meters) squared (i.e., kg/m2). Using this ratio, the BMI separates folks into the following categories:

  • Underweight (BMI < 18.5)
  • Normal weight (BMI 18.5 – 24.9)
  • Overweight (BMI 25 – 29.9)
  • Obese (BMI > 30)

Hence, the notion of “normal” weight, but as mentioned above, there are many limitations associated with the BMI for assessing health and fitness. Along those lines, recent research suggests that where you store body fat—even if you fit into the “normal” weight category—may drastically increase your risk of disease and death.

Obesity as Dangerous as Smoking

Normal Weight Obesity as Deadly as Smoking?

In a study published in the journal Annals of Internal Medicine, a group of researchers led by Dr. Francisco Lopez-Jimenez, director of preventive cardiology at the Mayo Clinic, examined 14 years’ worth of data. With over 15,000 study participants, the researchers were able to determine the potential connection between “normal weight obesity” and the risk of cardiovascular disease and death. They found that folks who are “normal weight” yet carry excess belly fat were more than twice as likely to die from cardiovascular disease compared to “obese” people whose body fat was more equally distributed throughout their bodies.1 That is, on their hips, backs, legs, etc.

To put the increased risk of disease into perspective, Dr. Lopez-Jimenez said, “Being normal weight with mid-section obesity is comparable to smoking a half to a full pack of cigarettes daily.”

So, regardless of weight, excess belly fat is a HUGE health problem (not to mention a tremendous setback to your confidence and self-esteem). It’s been associated with cardiovascular disease, stroke, diabetes, joint pain, back pain, and even cancer.2

So, if you are skinny fat or carrying some excess belly fat, what can you do?

Fortunately, there are four helpful keys to busting that blasted belly fat.

Skinny Fat

4 Tips to Fight Skinny Fat Body Shape


#1 Exercise

A sedentary lifestyle, overall lack of physical activity, and low levels of fitness are associated with excess belly fat. One of the hallmarks of being “skinny fat” is having lower levels of muscle mass. That is, your ratio of fat to muscle or body fat percentage is much higher than it should be for your weight.

Fortunately, a combination of resistance training and aerobic conditioning (including moderate and intense cardiovascular activity) can help reduce belly fat.3,4

The American College of Sports Medicine (ACSM) suggests combining moderate- with high-intensity exercise for at least 250 minutes per week.5 That’s well under an hour every day and can be accomplished with a variety of activities from hiking to yoga to dancing to weight training. However you enjoy moving your body!

#2 Nutrition
Not surprisingly, what and how you eat can both impact fat-storage patterns, including how much belly fat you carry.6,7 Studies show that when you combine regular physical activity with a reduced-calorie diet, you’ll drop MORE belly fat than if you did either on its own.8,9

Research suggests that reduced-calorie diets (regardless of macronutrient composition) are effective at slashing belly fat.  With that said, reduced-calorie diets that are higher in protein (i.e., > 0.5 grams of protein per pound of body weight per day) and “control” carbohydrates (i.e., <40% of calories from carbohydrate) may be most effective at reducing belly fat. 10DDI

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#3 Stress Management
Excessive stress or the inability to cope with stress can be a major contributor to storing fat around your waist. Stress can drive weight gain through both biological processes and by influencing your eating behaviors.14,15 You may be familiar with the “stress hormone” cortisol, which directly increases belly fat storage. Studies have shown that folks with high waist to hip ratios tend to have poor coping skills and secrete more cortisol when faced with a stressful situation.16,17 Of course, the effect of stress on eating behaviors is a profound one, and stress has been associated with higher caloric intake, increased saturated fat and sugar consumption, and poor diet quality.

While stress management can be tricky, yoga, meditation, mindful breathing (i.e., deep belly breathing), taking leisurely walks outdoors (e.g., “forest bathing”), healthy levels of physical activity, optimizing sleep, purposeful relaxation, managing finances, and cultivating healthy relationships can all contribute to reducing stress to healthy levels.

#4 Supplementation
Finally, there are certain herbs called adaptogens that may be helpful in reducing cortisol, improving stress levels, and promoting resilience. For instance, Rhodiola rosea and Ashwaghanda are adaptogens that have been shown to help promote resilience, reduce cortisol and stress levels, and reduce the incidence of stress-related eating.18,19

In addition, there may be additional nutrients that have a beneficial impact on reducing belly fat. For instance, there is evidence that supplementation with conjugated linoleic acids (CLA), fat-burning fats found in small amounts in dairy and meat, may preferentially reduce belly fat.20,21  Plus, any dietary supplement that can promote a negative energy balance (e.g., increase energy expenditure, reduce calorie intake) has the potential to reduce fat.

The Skinny on Skinny Fat

Scale weight and Body Mass Index are not always accurate or reliable tools to assess your health, fitness, and wellness. As strange as it sounds, it’s completely possible to be “normal” weight and metabolically obese—with the associated increased risk for disease and death.

Regardless of how much you weigh, if you store an excess amount of fat around your waist, there are significant health repercussions. The great news is that there are multiple factors—well within your control—that you can begin to address—RIGHT NOW—to combat that blasted belly fat.

Bonus Tip:

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References

  • 1. Sahakyan KR, Somers VK, Rodriguez-Escudero JP, et al. Normal-weight central obesity: implications for total and cardiovascular mortality. Ann Intern Med. November 2015. doi:10.7326/M14-2525.
  • 2. Dixon JB. The effect of obesity on health outcomes. Mol Cell Endocrinol. 2010;316(2):104-108. doi:10.1016/j.mce.2009.07.008.
  • 3. Moore DR, Tang JE, Burd NA, Rerecich T, Tarnopolsky MA, Phillips SM. Differential stimulation of myofibrillar and sarcoplasmic protein synthesis with protein ingestion at rest and after resistance exercise. J Physiol. 2009;587(Pt 4):897-904. doi:10.1113/jphysiol.2008.164087.
  • 4. Hansen E, Landstad BJ, Gundersen KT, Torjesen PA, Svebak S. Insulin sensitivity after maximal and endurance resistance training. J Strength Cond Res Natl Strength Cond Assoc. 2012;26(2):327-334. doi:10.1519/JSC.0b013e318220e70f.
  • 5. Donnelly JE, Blair SN, Jakicic JM, Manore MM, Rankin JW, Smith BK. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc. 2009;41(2):459-471. doi:10.1249/MSS.0b013e3181949333.
  • 6. Maersk M, Belza A, Stodkilde-Jorgensen H, et al. Sucrose-sweetened beverages increase fat storage in the liver, muscle, and visceral fat depot: a 6-mo randomized intervention study. Am J Clin Nutr. 2012;95(2):283-289. doi:10.3945/ajcn.111.022533.
  • 7. Stanhope KL, Schwarz JM, Keim NL, et al. Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans. J Clin Invest. 2009;119(5):1322-1334. doi:10.1172/JCI37385
  • 8. de Souza RJ, Bray GA, Carey VJ, et al. Effects of 4 weight-loss diets differing in fat, protein, and carbohydrate on fat mass, lean mass, visceral adipose tissue, and hepatic fat: results from the POUNDS LOST trial. Am J Clin Nutr. 2012;95(3):614-625. doi:10.3945/ajcn.111.026328.
  • 9. Bradley U, Spence M, Courtney CH, et al. Low-fat versus low-carbohydrate weight reduction diets: Effects on weight loss, insulin resistance, and cardiovascular risk: a randomized control trial. Diabetes. 2009;58(12):2741-2748. doi:10.2337/db09-0098.
  • 10. Miyashita Y, Koide N, Ohtsuka M, et al. Beneficial effect of low carbohydrate in low calorie diets on visceral fat reduction in type 2 diabetic patients with obesity. Diabetes Res Clin Pract. 2004;65(3):235-241. doi:10.1016/j.diabres.2004.01.008.
  • 11. Skov AR, Toubro S, RS, Rj.diabres.2004.01.008.08..008..ts on von protein vs carbohydrate in ad libitum fat reduced diet for the treatment of obesity. Int J Obes Relat Metab Disord J Int Assoc Study Obes. 1999;23(5):528-536.
  • 12. Due A, Toubro S, Skov AR, Astrup A. Effect of normal-fat diets, either medium or high in protein, on body weight in overweight subjects: a randomised 1-year trial. Int J Obes Relat Metab Disord J Int Assoc Study Obes. 2004;28(10):1283-1290. doi:10.1038/sj.ijo.0802767.
  • 13. Noakes M, Keogh JB, Foster PR, Clifton PM. Effect of an energy-restricted, high-protein, low-fat diet relative to a conventional high-carbohydrate, low-fat diet on weight loss, body composition, nutritional status, and markers of cardiovascular health in obese women. Am J Clin Nutr. 2005;81(6):1298-1306.
  • 14. Block JP, He Y, Zaslavsky AM, Ding L, Ayanian JZ. Psychosocial stress and change in weight among US adults. Am J Epidemiol. 2009;170(2):181-192. doi:10.1093/aje/kwp104.
  • 15. Richardson AS, Arsenault JE, Cates SC, Muth MK. Perceived stress, unhealthy eating behaviors, and severe obesity in low-income women. Nutr J. 2015;14:122. doi:10.1186/s12937-015-0110-4.
  • 16. Epel ES, McEwen B, Seeman T, et al. Stress and body shape: stress-induced cortisol secretion is consistently greater among women with central fat. Psychosom Med. 2000;62(5):623-632.
  • 17. Morris KL, Zemel MB. 1,25-dihydroxyvitamin D3 modulation of adipocyte glucocorticoid function. Obes Res. 2005;13(4):670-677. doi:10.1038/oby.2005.75.
  • 18. Auddy B, Hazra J, Mitra A, Abedon B, Ghosal S. A standardized Withania somnifera extract significantly reduces stress-related parameters in chronically stressed humans: a double-blind, randomized, placebo-controlled study. JANA. 2008;11(1):50-56.
  • 19. Darbinyan V, Kteyan A, Panossian A, Gabrielian E, Wikman G, Wagner H. Rhodiola rosea in stress induced fatigue--a double blind cross-over study of a standardized extract SHR-5 with a repeated low-dose regimen on the mental performance of healthy physicians during night duty. Phytomedicine Int J Phytother Phytopharm. 2000;7(5):365-371. doi:10.1016/S0944-7113(00)80055-0.
  • 20. RiséRis U, Berglund L, Vessby B. Conjugated linoleic acid (CLA) reduced abdominal adipose tissue in obese middle-aged men with signs of the metabolic syndrome: a randomised controlled trial. Int J Obes Relat Metab Disord J Int Assoc Study Obes. 2001;25(8):1129-1135. doi:10.1038/sj.ijo.0801659.
  • 21. RiséRis U, Arner P, Brismar K, Vessby B. Treatment with dietary trans10cis12 conjugated linoleic acid causes isomer-specific insulin resistance in obese men with the metabolic syndrome. Diabetes Care. 2002;25(9):1516-1521.
  • Billy Padgett

    Can a person have 4 eggs half pound bacon toast with chocolate gravy grits hash browns and maintain his goal of 2000 carolies a day?

    • Cristina

      Hi Billy. Chocolate gravy? I would have said yes, but the chocolate gravy was pushing it. 😉

      While it has been proven that reducing your calories (despite macronutrient composition) has been effective at reducing belly fat, this does not necessarily mean one can be sedentary, or forego other healthy habits, and get 6-pack abs. As mentioned in the article above “reduced-calorie diets that are higher in protein (i.e., > 0.5 grams of protein per pound of body weight per day) and “control” carbohydrates (i.e., <40% of calories from carbohydrate) may be most effective at reducing belly fat."

      What you ultimately choose to eat will determine your level of satiety, how soon you will experience hunger or cravings, and how long your energy levels will be sustained. For example, a chicken breast and a donut both contain the same amount of calories, however the hormonal impact will play a large role in how your body reacts to these foods.

      It is important to be mindful of consuming nutrient dense foods, and in taking a lifestyle-based approach to optimizing health, fitness, and performance. Practice good nutrition behaviors, engage in regular physical activity, and learn how to effectively manage stress. These habits will not only improve your physical well-being, but also your mental and emotional well-being.

  • Cande Kirk

    Hi! I have lost 61 pounds in the last 7-8 months but I have no muscle mass. I have been reading everything from Bio-Trust and I don’t know what I need the most….the protein powder or these greens…or the probiotics. I am 61 years old and I have FMS and Chronic Fatigue plus other health issues and I am on disability. I have been on prednisone for years but I am down to a very low dose of 6mg. I wish I had the money to buy it all but I don’t. Can you recommend what I should start with? Thank you. Cande

    • Hi Cande,

      I hope this finds you doing well! And why wouldn’t it? It sounds like you’ve made some tremendous progress toward a healthier body weight, which can have a significant impact on how you look and feel as well as overall health. Congratulations!

      Before continuing, I do have to remind you that our products and the information that we provide are not intended to diagnose, treat, cure, or prevent any medical conditions. We advise folks who are taking medications and/or being treated for medical conditions to consult with their physicians before taking any new supplements, making any changes to their diets, or starting a new exercise program.

      Having said that, I’ll be happy to provide some general information that applies to otherwise healthy adults that I encourage you to discuss with your medical team to decide what’s best for you.

      Unfortunately, as folks age, there tends to be a slow and inevitable age-related decline in skeletal muscle mass, accompanied by a decline in strength, which has tremendous consequences for mobility and physical function and is associated with a greater incidence of falls in the aging population. What’s more, the age-related losses in muscle mass also contribute to a number of age-related health conditions that can reduce independence and lessen the quality of life.

      Although we will all lose muscle mass as we age—beginning around the age of 40 – 50 years old at a rate of about 0.6% per year—there are a number of factors (within your control) that can affect the rate of muscle loss. For instance, inactivity or immobilization can accelerate the rate at which muscle is lost. In other words, “use it or lose it.” Conversely, resistance training (i.e., weight lifting) is the most potent stimuli for staving off age-related losses in muscle mass.

      What’s more, nutritional factors can also influence the rate of muscle loss. For instance, protein intake has a tremendous impact on building and maintaining muscle. However, older adults tend to consume a suboptimal protein intake, which contributes to age-related muscle loss. On top of that, it appears that, as we age, we have a reduced sensitivity to the effects of dietary protein. In other words, more dietary protein is needed to help build and maintain skeletal muscle mass as we age. In fact, it may take up to 67% more protein per meal for older adults to stimulate muscle protein synthesis to a comparable level as young adults.

      Along those lines, for an otherwise healthy adult looking to build muscle mass, a combination of regular resistance training and optimizing protein intake, which may involve using a protein supplement, are foundational.

      Lastly, one additional resource that I think you might find useful is the following article from our good friends at Precision Nutrition:

      Living Well with Fibromyalgia

      I hope that you find this helpful, Cande; keep up the great work and let us know how we can help!

      Coach Tim

      • Cande Kirk

        Thank you coach Tim for your reply! I think the protein would be the best place to start but I wanted to ask you about the free bottle of Metabo#374…I forgot the name of it and I just read about it….hat is how bad my short term memory is at times. I didn’t know if I could try both of them. I also wanted to ask you if you knew anything about high potassium levels? I just got my blood test results in the mail yesterday and the doctor wants me to come back in for another blood test because of a high potassium level. I have been eating so good and drinking a healthy smoothie each morning for breakfast. I usually just put in a carrot, apple, pear, avocado, kale, spinach, ginger, a frozen berry mix and add coconut milk. I cannot understand why my potassium would be high or why I also my cholesterol was 238. I have worked so hard on losing weight and trying to feel better by eating clean and this was so disappointing. I just want to feel better and have some energy. The article on FMS was one of the best ones I have ever read…thank you for that. I am going to start back doing some low impact exercise and try some light weights like you suggested. Thank you for any help you can give me. Cande

        • Hi Cande,

          Thank you so much for your reply; it’s great to hear from you! It’s absolutely my pleasure to help, and I’m glad that you found the information I shared to be useful.

          With regard to Metabo379 (you were very close!) and weight loss supplements in general, I encourage you to take a look at the following article that we just published:

          4 Weight-Loss Supplements That Don’t Work

          Specifically, the section titled Sphaeranthus indicus and Garcinia mangostana pertains to Metabo379, as those are the supplement’s primary ingredients. As you’ll see, there is strong supporting evidence that, when combined with a healthy eating plan and regular physical activity, this herbal blend can significantly enhance weight loss and promote major cardiovascular benefits (such as supporting healthy levels of cholesterol and triglycerides).

          As I mentioned in my initial response, we do recommend that folks who are taking medications and/or being treated for any medical conditions consult with their physician prior to using any new supplements or starting a new diet or exercise program. You can find more information (including the Supplement Facts Panel, which includes the ingredients, and scientific references) on the Metabo379 product page. I see that you also mentioned the 15-day trial-size bottle, which can be found here.

          With regard to your lab work, I appreciate you asking and inviting me to share my input. Unfortunately, I’m not medically trained to interpret your test results, and given that I have very limited information about your health history, I think it would be irresponsible for me to do so. Your doctor is best suited to review these results with you, and if you’re not completely please or you don’t necessarily agree with the prognosis, then I would suggest soliciting a second (medical) opinion.

          To speak briefly and generally with regard to metrics of cardiovascular health (e.g., cholesterol, triglycerides), I think it’s important to take a look at the complete picture. While most people have been trained to believe that total and LDL (the so-called “bad” cholesterol) are the be-all, end-all markers of cardiovascular wellness, the growing body of recent research is opening our eyes to other (arguably more important) factors/metrics.

          The American Heart Association “urges all Americans to have their physicians determine their total and HDL blood cholesterol levels.” The optimum cholesterol ratio (obtained by dividing the high-density lipoprotein
          (HDL or “good”) cholesterol level into the total cholesterol) is 3.5:1.

          In addition, there is now more emphasis on looking at non-HDL cholesterol, which would include very low density lipoproteins and Apo-B, which is a small, dense chylomicron remnant. Apo-B is considered by some to be a better predictor of cardiovascular risk than the more commonly used LDL. In addition, C-reactive protein (CRP), homocysteine, and triglycerides are other blood variables that are often considered when painting the complete picture of cardiovascular wellness.

          I hope that you find this helpful, Cande. Please keep us posted, and please let us know if you have any questions. Keep up the good work!

          My best,

          Coach Tim

          • Cande Kirk

            Thanks so much Coach Tim for all your help, info and advice!! I just received my Low Carb Protein mix in the mail yesterday and I was surprised to see how big it was!! I am so excited to start adding it to my daily Ninja juice. My doctor says he doesn’t know anything about all the supplements and “health junk” and I thought that was very sad. He just said to eat right and to keep doing what I am doing because I have lost 65 pounds so far….but he doesn’t understand that I just want to feel better and have more energy. Having FMS, CFS and Arthritis and other issues makes life hard and all my doctors want to do is throw more medicine at me. My Rheumatologist got upset because I have slowly stopped taking some of the medicines I was on. I am going to try whatever I can to get better and I am so thankful for Bio-Trust. I was thinking about trying the Ageless Body next… unless you can think of anything else. Also, what do you think about the essential oils? I have been reading up on them, but I don’t know anyone personally that uses them. I do believe that the best thing I can do for myself is to take your advice and start back with my low impact exercise and to add some weights to my routine. Thanks again for your help! Cande

  • Cristina

    Greetings Lea. Thank you for taking the time to provide us with your feedback.

    We welcome all comments and feedback, and while the majority of that is positive, we accept criticism with open arms as well.

    I agree that sometimes “less is more”, and we do strive to find a balance between giving as much supporting information as we can versus providing succinct answers.

    If there are any topics you would like to know more about, or if you would like additional information, please let us know.