What Does ‘Skinny Fat’ Mean?

If you’ve never heard of the term “skinny fat,” you’re likely wondering what it means. It sounds paradoxical at best, and downright judgey to say the least.

So, what do people mean when they say “skinny fat”? And what does it say about your health?

Clinical psychologist and weight management specialist Leslie Heinberg, PhD, explains.

What is ‘skinny fat’?

“Skinny fat” isn’t a medical condition or a medical term, but it refers to having a body mass index (BMI) in a normal range while also having health concerns that are often associated with having obesity, like:

• High body fat percentage (or, put another way, low muscle mass)
• Heart disease
• Diabetes or prediabetes
• High blood pressure
• High cholesterol
• High triglycerides

Skinny fat isn’t a medical diagnosis, so there isn’t a clear definition. But the gist is that it’s an internet-created term based on an assumption that these health conditions aren’t “supposed” to happen to people who are at a healthy weight.

That thought process is flawed.

“We know that chronic health conditions can affect anyone of any BMI at any time. So, labeling people as ‘skinny fat’ — putting two adjectives together that are often used to stigmatize — isn’t only judgmental, it’s also misleading,” Dr. Heinberg points out.

Does having obesity (BMI 30+) increase your risk for heart disease and the like? Yes.

But does having a normal BMI (18.5 to 24.9) mean you’re safe from chronic disease? Nope.

BMI is a calculation of your weight-to-height ratio. And it’s far from perfect. For example, BMI doesn’t consider factors like your waist circumference or body fat percentage — which can make a big difference in your health.

“Just because somebody’s BMI is elevated doesn’t necessarily mean that they have risk factors or are unhealthy. And just because somebody’s BMI is in the normal range doesn’t automatically mean they’re healthy,” Dr. Heinberg clarifies.

BMI is a tool that can help you get a high-level overview of your health. But it’s not a crystal ball. It can’t be relied on as the sole source of truth about your health.

What causes skinny fat?

Both your genetics and your lifestyle have big roles to play in your BMI and your risk for health conditions, including the ones associated with “skinny fat.”

“Your weight is as determined by genetics, as your height is,” Dr. Heinberg shares. “Genetics give us a kind of window in which we can land. And through our behaviors, we can influence where we fall within that window.”

Consider two people:

• Person A doesn’t pay much attention to their diet and gets limited physical activity. Yet they remain at a healthy BMI.
• Person B strictly follows a well-balanced diet, exercises regularly and still remains firmly at the higher end of the BMI scale.

Metabolically speaking, person A may be at risk for skinny fat. Even though their weight isn’t affected by a less-than-healthy lifestyle, the inner workings of their body are.

Eating a diet high in saturated fats, sugar and processed foods doesn’t give your body the vitamins and minerals it needs. It can’t as easily manage things like blood pressure and keep your cholesterol levels healthy when it’s not fueled properly. And limited physical activity allows adipose (fat) tissue to build up, reducing lean muscle mass and wreaking havoc across your body.

That all means person B could be at a lower risk for chronic disease, despite their higher BMI.

Healthy lifestyle for skinny fat (and everyone)

The key to protecting yourself from chronic conditions associated with skinny fat lies in a healthy lifestyle.

“Everybody benefits from eating a healthy diet, and everybody benefits from increasing their physical activity,” Dr. Heinberg reminds us. “It doesn't matter what weight you are, meeting your nutritional goals and getting regular exercise are important to staving off a slew of health conditions.”

Eating well and exercising help build muscle, which keeps fat from accumulating. If your BMI is in the healthy range, your goal shouldn’t be to lose weight. Rather, to replace fat with muscle.

Follow these tips:

• Get 150 minutes a week of moderate-intensity cardio exercise, like walking, jogging, swimming and high-intensity interval training.
• Participate in strength-training exercise at least twice per week (think kettlebells, free weights, resistance bands and such).
• Eat a healthy diet that emphasizes more whole, natural foods and fewer processed and packaged foods. The Mediterranean diet can be a good start.
• Keep up with annual check-ups, including any bloodwork your healthcare provider recommends. The more you know about where you stand, the better you can care for yourself.

Skinny fat may not be a medical diagnosis itself. But the health conditions that arise from a less-than-optimal lifestyle are very real. And they can do lasting damage across your body. Talk with a healthcare provider about your risk and how to live your healthiest life.