Normal Weight Obesity: When Thin Is Fat

Is Normal Weight Obesity a Hidden Health Risk?

Normal-body mass index (BMI) individuals who have high body fat percentages exhibit severe metabolic dysregulation. This condition, which is referred to as normal weight obesity, is linked to a significantly increased risk of developing metabolic syndrome, cardiometabolic dysfunction, and higher mortality.

Obesity is a condition that involves having too much body fat. It raises your risk of developing additional illnesses and medical issues, including heart disease, diabetes, high blood pressure, and particular types of cancer.

Weight is not a reliable indicator of obesity; body fat percentage is. You can be obese and have a normal weight if your body fat percentage is high enough; this condition is known as normal weight obesity. And you could face the same grave health risks as someone who is overweight normally.

The ideal weight for everyone varies because each person is unique and depends on several factors. Age, height, and natal sex are examples of biological factors, but mental factors can be just as significant.

The weight at which a person feels the most at ease may be their ideal weight. However, maintaining a healthy weight can lower a person’s risk of contracting several illnesses, for example:

  • Type 2 diabetes
  • Obesity
  • High blood pressure
  • Cardiovascular disease (CVD)

But not everyone who is overweight will experience health problems. Researchers do think that even though the extra weight may not currently be having an adverse effect on health, future issues with weight management may arise.

Studies that shed light on different types of obesity other than the traditional model based on body mass index have been conducted because of the growing concern regarding the effects of overweight on health. Overweight body fat in people with a healthy body mass index is referred to as normal-weight obesity.

A higher body fat percentage raises condition raises the risk of cardiovascular morbidity and mortality as well as other conditions like insulin resistance, hypertension, and dyslipidemia that are linked to chronic diseases.

If not controlled, normal-weight obesity (high body mass index with “normal” weight) can result in health problems

Normal weight obesity (NWO) is a disease that can affect people with any body mass index (BMI). Even though it may sound contradictory, a growing body of research shows that a high body fat percentage is a genuine health issue. Even if you are within the normal weight range, you could still experience weight-related health problems.

The potential role(s) that obesity may play in the emergence of cardiovascular disease, particularly congestive heart failure, is receiving more and more attention (CHF). There are several indirect or related effects that could be at fault. For instance, several atherosclerotic risk factors, such as arterial hypertension, insulin resistance, diabetes, and dyslipidemia, are strongly correlated with obesity.

Therefore, it is not surprising that coronary artery disease, a common precursor of CHF, tends to occur prematurely and rapidly in obese people. Obesity has been linked to atrial fibrillation, another condition that can lead to CHF, in addition to promoting coronary heart disease.

In a different study, which was reported in the American Journal of Clinical Nutrition in January 2007, researchers discovered that women with NWO had higher levels of inflammatory biomarkers, which put them at risk for developing early inflammation, cardiovascular disease, and metabolic syndrome.

How to manage a “skinny fat” body fat percentage

Unfortunately, there are times when we evaluate our self-worth based on the weight we see when we step on the scale in the morning. The bathroom scale can be a helpful tool for detecting obesity or monitoring weight loss progress, but for many of us, it can be incredibly misleading. This applies to skinny fat people as well as athletes who weigh more than usual, especially if it gives you confidence that your weight is healthy.

The management of NWO is more complex than simply advising a client or patient to lose weight. The weight of individuals with a skinny fat body type is not the problem. Rather, a body composition defined by low lean body mass coupled with a high-fat mass is the issue. Simply advising these clients to lose weight will often result in muscle loss and exacerbation of the skinny fat body type.

Get fit but don’t just move more

In cases of NWO, simply moving more might not be sufficient. Walking, cycling, dancing, running, and swimming are all cardiorespiratory-based exercises that can help increase daily energy expenditure, improve cardiorespiratory health, and reduce fat mass. However, the body will require more stimulation to increase lean body mass.

Instead, emphasis should be placed on resistance training to increase bone and skeletal muscle mass; light weights and high repetitions are not the solutions. The body must instead be subjected to loads and mechanical stress that are greater than what is required for daily survival.

Improve your diet

Reversing a skinny fat body type is largely dependent on practicing optimal nutrition. In these people, significant caloric deficits frequently result in a greater loss of lean body mass. Small caloric deficits and high protein intakes can support ideal body composition if fat loss is the goal.

Increases in lean body mass and decreases in fat mass can be supported by daily intakes of body weight. Older adults are especially affected by this. In addition, eating a diet moderate in fats and carbohydrates, cutting back on refined sugar, and making sure you get enough fiber can all help. Our licensed nutritionists at VIDA Bariatrics can review your medical history and assess your nutritional and physical fitness profile.

Lessen anxiety and inflammation

Keep in mind that NWO is frequently linked to an inflammatory state. The management of NWO will also benefit from getting enough sleep (7 to 8 hours each night), taking some downtime, and developing healthy cortisol-reducing routines.

BMI can be very deceptive in NWO cases (skinny fat body type). In addition to routine health screenings, adults who are sedentary and believe they may have skinny fat body types should think about getting their body composition measured.

Instead of just trying to lose weight, people with NWO should concentrate on improving body composition by increasing lean body mass through resistance training, appropriate dietary changes, and stress reduction techniques. Get your protein, move around, sleep, and lift heavy objects!

If what you want is to get help regarding your dietary plans, and what changes you can make and aid you in your weight loss goals visit VIDA Bariatrics to get started and learn more.


Dr. Gabriela Rodriguez specializes in General and Laparoscopic Bariatric Surgery. She brings to VIDA Wellness and Beauty a wealth of experience in bariatrics. Dr. Rodriguez is a founding associate of the Mexican College of General Surgeons. A world-class bariatric surgeon with double certification in the US and Mexico.