Skinny Fat People?

While we know that 68 per­cent of the American pop­u­la­tion is over­weight, and that most have dia­besity—being some­where on the con­tin­uum of pre-diabetes to Type 2 diabetes—the shock­ing news from a study pub­lished in the Journal of the American Medical Association is that nearly 1 in 4 skinny peo­ple have pre-diabetes and are “meta­bol­i­cally obese.”

What’s worse is that if you are a skinny fat per­son and get diag­nosed with dia­betes, you have twice the risk of death than if you are over­weight when diag­nosed with dia­betes. Perhaps hav­ing that extra mus­cle on your body from hav­ing to carry around those extra pounds pro­tects you.

Studies on teenagers found that 37 per­cent of the skinny kids had one or more signs of pre-diabetes such as high blood pres­sure, high blood sugar, or high cho­les­terol. Wait—almost four out of 10 normal-weight kids are pre-diabetic?

It is bad enough that one-third of kids are over­weight or obese in America, but now it appears that only about 20 per­cent of chil­dren in America are healthy. In other words, 8 out of 10 chil­dren in America are over­weight or have pre-diabetes or Type 2 diabetes.

In my med­ical prac­tice I see this all the time. Jim came in for a “well­ness check up” and felt happy about his weight. His BMI (or body mass index) was 22 (nor­mal is 18 to 24.)

He never seemed to gain weight and felt he could “tol­er­ate” a diet that included lots of bread, pasta, and sugar. He liked his two sodas a day and a few glasses of wine at night. He walked but didn’t do much vig­or­ous exer­cise or weight training.

When we looked under the hood we found he had a blood sugar of 117 mg/dl (pre-diabetes), triglyc­erides of 350 mg/dl, and an HDL of 35 mg/dl. His blood pres­sure was 148/96 mmHg (nor­mal is less than 110/75 mmHg).

And when we mea­sured his insulin lev­els after tak­ing a sugar drink, they were sky high. Insulin is the real cul­prit here—it is the fat stor­age hor­mone. It stores belly fat and leads to hor­monal and meta­bolic changes that cause mus­cle loss and inflam­ma­tion, fur­ther­ing the vicious cycle of pre-diabetes or Type 2 diabetes—whether you are skinny or fat.

He was shocked to find out he had severe pre-diabetes and was a tick­ing time bomb for a heart attack, stroke, and even can­cer and demen­tia. I treated Jim exactly the same way as my patients with Type 2 diabetes.

Get the Right Tests

So how do you know if you are a skinny fat per­son? There are a few cri­te­ria you can use that can help you iden­tify your­self as hav­ing dia­besity or being “skinny fat,” includ­ing fam­ily his­tory of Type 2 dia­betes or early onset of heart dis­ease (heart attack in rel­a­tive under 50 years old), or even look­ing down and see a lit­tle pot belly. And if you are of Asian or Indian descent, you can get dia­besity at a much lower body weight.

Click here to read the rest of this arti­cle at HuffingtonPost.com.