When looks can deceive: 'Skinny fat' is real and your organs are paying the price

You can be thin on the outside but unhealthy on the inside. The culprit is visceral fat, which packs itself around the organs deep inside your abdomen. It is entirely different from subcutaneous fat—the pinchable layer under your skin. While subcutaneous fat mostly acts as insulation, visceral fat actively interferes with your internal health.

The metabolism of visceral fat means that having too much of it affects bodily processes, such as inflammation and glucose metabolism.

When a slim appearance can be deceptive

According to Dr Gausiya Aziz, Consultant - HOD – Nutrition & Dietetics, SPARSH Hospital, Yelahanka, Bangalore, body weight and Body Mass Index (BMI) are very good indicators, but they do not necessarily reflect the distribution of fat in the body.

“We do come across people who seem lean or whose BMI is normal but have more fat content in the abdomen or visceral fat, especially when muscle mass is less and physical activity is insufficient.

“Such individuals must never take for granted that their body does not pose any metabolic risks just because they are not overweight. Measures like waist circumference, blood pressure, blood glucose, HbA1C, cholesterol levels, and lifestyle and family history are much better predictors of metabolic risks,” says Aziz.

Waist size, lack of physical activity, unhealthy eating practices and presence of a family history of diabetes may call for more focus even in individuals who have normal weight levels. Research indicates that visceral fat has been linked to the development of insulin resistance and type 2 diabetes.

Why visceral fat is a concern

While subcutaneous fat is located beneath the skin, visceral fat packs around the vital organs in the abdominal cavity. Additionally, visceral fat has been shown to be linked with various metabolic problems. It will lead to inflammation and metabolic disorders in both fat and carbohydrate metabolism.

Eventually, this condition will give rise to metabolic disorders, fatty liver disease, and heart ailments. It can even affect fat metabolism and insulin resistance in the body. Thus, it becomes extremely important to diagnose this condition in its early stages.

The ‘Thin Outside, Fat Inside’ phenomenon

“Being thin from the outside is not equivalent to having a healthy body composition. Clinically speaking, one must know about what's underneath and look into various aspects like belly fat, muscle mass, eating habits, physical activity and metabolic profile. An individual who is slim and has a growing waistline, weak muscles, a poor lifestyle, or high sugar and fats in the blood cannot be said to be metabolically fit. The goal is to improve body composition and metabolic profile, not just achieve or maintain a certain weight,” explains Dr Dinesh Thakur, Senior Consultant- Advanced Laparoscopic & Bariatric Surgery, Apollo Spectra Hospital, Delhi.

What can increase visceral fat?

Some potential causes of abdominal fat accumulation include a sedentary lifestyle, excessive consumption of high-calorie foods, lack of sleep, stress, and prolonged sitting. Muscle weakness is another potential cause of poor body composition. Ageing, long-term stress, and disrupted daily schedules can contribute to fat distribution and increase the risk of fat accumulation around the abdomen.

How can the risk be reduced?

The primary aim should be not only to lose weight but also to maintain proper body composition and metabolic rate. Having regular exercise sessions will help one lose excess body fat from the stomach and build muscle mass.

Eating a healthy diet full of protein, fibre, and fruits is a great way to keep your metabolism active. However, nutrition is only part of the equation; getting enough sleep and avoiding prolonged sitting are just as important.

Those with an expanding waistline, high blood sugar levels, abnormal cholesterol levels or any other metabolic risk factors need to consult a doctor. In the end, however, the scales will not give the whole picture. Even a physically fit body could be carrying metabolic problems inside, which means that awareness and proper maintenance are crucial even for those who are physically fit.

Nivedita is a freelance writer. She writes on health and travel.