Are you 'skinny fat'? Here's what to know about it and why your BMI can be misleading
Normal-weight obesity seems like an odd misnomer, a joke, but it's not. For decades, I have argued against the use of body weight as an indicator of health because it can be misleading. A case in point is the misuse of the Body Mass Index (BMI), a measurement derived by dividing body weight by height. Thankfully, there is some momentum mounting to quit using BMI as an indicator of obesity and health status.
The BMI was originally intended to be used as an epidemiologic tool, a way to describe populations. It could be used to compare Mexico with the U.S., and a higher BMI would suggest a more obese society. However, over the years the BMI has been used inappropriately to categorize individuals.
For context, here is the BMI scale:
Underweight: BMI is less than 18.5
Normal weight: BMI is 18.5 to 24.9
Overweight: BMI is 25 to 29.9
Obese: BMI is 30 or more
Here is a personal example. As a graduate student in my twenties, I exercised constantly, running and lifting weights. Our laboratory developed a hydrostatic (underwater) weighing station that provides an accurate measurement of body fatness, and we all went into the tank. Body fat was determined, then we calculated BMI. At 6 feet 2 inches and 238 pounds, my BMI was 30.6.
Because my BMI was above 30, I would be considered obese. But was I obese?
Results of my body fat test revealed that I was incredibly lean at 8% body fat with a sculpted 32-inch waist. By comparison, another male grad student was 5 feet 10 inches and 172 pounds, and his BMI was calculated to be 24.7, normal weight. I was deemed obese at 8% body fat, while he was considered "normal" at 21% body fat with a soft, poochy belly.
Let me add something I wrote about in the past. I became a graduate student even though my goal was to be a Pennsylvania State Trooper. This was the motivation behind my many years of gut-busting training from ages 14 to 21. I figured if you are going to be a cop, you had better be able to chase down bad guys. So, I devoted myself to developing my body, plus I learned to fight, winning the Diamond Belt boxing championship in Pittsburgh as a heavyweight.
I was ready and eager to be a cop and arrogantly assumed that when they saw me, they would gush with enthusiasm. Instead, when I went for an interview, the guy behind the desk with skinny arms and a pot belly looked me over and asked my height and weight. I told him the same figures as above, 6 feet 2 inches, 238 pounds. He nodded, opened a drawer, pulled out a sheet and ran his finger down a column, then said, "195."
I said, "Huh? 195 what?"
He replied: "Son, at your height you can’t weigh more than 195 pounds. According to this, you are obese and are disqualified."
Thus ended my dream of being a cop.
What is 'skinny fat?'
Normal-weight obesity is also known as "skinny fat" and demonstrates how your body weight, and especially your BMI, can be misleading when it comes to body fatness. It also is a misleading indicator of health. It is estimated that as many as one-third of the population qualifies as "skinny fat" with a BMI between 18.5 and 24.9.
"Skinny fat" people may look trim and healthy in their clothes, but a closer look reveals lots of flab which promotes inflammation, a core root of most of our health problems. These "skinny fat" folks are at high risk for heart disease and insulin resistance leading to Type 2 diabetes, but they often are given a pat on the back for seemingly managing their weight so well. The key is that being heavier is not always a health problem, and being lighter in weight does not necessarily mean you are healthy.
How do you know if you are 'skinny fat'?
Don’t assume you are healthy because you have a favorable BMI. Instead, have a checkup to determine your blood pressure, cholesterol, and blood sugar levels. What else can you do right now to see if you may qualify as "skinny fat" even though your BMI says you are doing fine?
As I have written many times, when it comes to body fat, stand naked in front of a large mirror and that will tell you all you need to know. Of special significance is how your body fat is distributed. Belly fat is dangerous, and this is called the "apple" shape. Belly fat is more common in men and post-menopausal women, and it’s problematic because it contributes to insulin resistance and inflammation. Lower body fat on the hips, thighs, and buttocks, more typical in younger women, does not carry the same health risk as belly fat.
A second way to check your "skinny fat" status is to look for discernable muscle mass. You can be underweight and still have high levels of body fat if you lack muscle mass. Years ago, back in the mid-1970s, we tested the body fat of members of the Louisville Police Department, including the chief who at 6 feet 3 inches and 190 pounds looked striking in his uniform. By contrast, another officer who came with him to be tested was shorter and much heavier and looked like he was packed into his uniform. As it turned out, the chief had very little muscle mass and his body fat percentage was quite high. The other officer had been a collegiate wrestler with plenty of muscle mass and a much lower percent body fat.
If you are older, please disregard the BMI. Chances are good you have lost muscle mass over the years unless you lift weights to preserve it. In turn, less muscle mass likely means you have a lighter body weight and a lower BMI. Again, the irony is, you probably are carrying too much excess body fat despite the lower BMI. In other words, you are "skinny fat." I suggest you put effort into resistance training to preserve and possibly reclaim some muscle mass.
Reach Bryant Stamford, a professor of kinesiology and integrative physiology at Hanover College, at stamford@hanover.edu.
This article originally appeared on Louisville Courier Journal: What is skinny fat? Why BMI can be a misleading health measure
