The dangers of being skinny fat

Even if you’re not obese, carrying fat around your midsection can be dangerous.

New research published in the journal Annals of Internal Medicine has revealed that healthy weight people who have fat around their middle have a higher mortality risk than people who are overweight or obese.

The study examined survey results of over 15,000 adults between 18 and 90. Looking at 14 years worth of follow up data they set out to see how heart-related mortality and total risk of death were related to the distribution of fat.

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People who had a normal body mass index (BMI) but a high hip-to-waist ratio had a higher risk of death than those with a higher BMI but a more even distribution of fat.

While the study didn’t offer an explanation why, researchers suspect that it could be due to visceral fat – the fat stored around the belly. Visceral fat is linked to high insulin resistance and chronic inflammation and is thought to be more dangerous than usual subcutaneous fat.

“Persons who are overweight or obese based on BMI may have larger amounts of subcutaneous fat in the hips and legs – fat linked to healthier metabolic profiles,” study authors wrote. “This may explain the unexpected better survival in overweight or obese persons, even among those who were centrally obese.”

As obesity is a risk factor in lifestyle-related disease including heart disease and type-2 diabetes, this study adds another level to the complex BMI debate. They suggest that people who do carry weight around their mid-section have the potential for significant lifestyle changes.

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“Our findings may have significant clinical implications because persons with normal BMI and central obesity were not considered a priority population for prevention programs by guideline developers,” the researchers wrote.

The study highlights that the BMI may not be the best indicator of a person’s health. In this study, researchers examined both BMI and hip-to-waist ration, which may be a more accurate measurement.

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Authors state that more research is needed to understand what contributes to central obesity and its health outcomes, other measurements may be worth considering.

“To better target persons at greatest risk, such as those who already have excess or increasing levels of adiposity or those with disproportionate abdominal fat in relation to BMI, these new data provide evidence that clinicians should look beyond the BMI,” wrote Dr Paul Poirier of Université Laval in Quebec.

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