Being Skinny-Fat May Be Worse Than Being Fat

Being Skinny-Fat May Be Worse Than Being Fat
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The average sumo wrestler in Japan has a body mass index of 56 (considered morbidly obese) and eats 5,000 calories a day. But despite those inflated and alarming numbers, the "rikishis" (wrestlers) who practice this time-honored sport aren't as unhealthy as one might expect.

"They have low cholesterol, they have low insulin resistance and a low level of triglycerides [fatty acids]," Jimmy Bell, a professor at Imperial College, London told The Guardian.

How can this be? Well, while sumo wrestlers may have blubbery outsides, they have muscular insides. The training and exercise keeps their hearts strong and pumping, relegating much of fat formed in the wake of their gluttonous eating to the outsides of their bodies, where it serves as a protective layer rather than an internal roadblock. Evidence shows that sumo wrestlers do have a shorter life expectancy than typical Japanese men, perhaps due to problems adapting to normal life in the wake of their strenuous, structured careers, and blows sustained during them, much like NFL football players. Still, during his sporting tenure, a sumo wrestler is quite healthy. Maybe not as fit as a fiddle, but perhaps as fit as a cello.

For as many as a quarter of normal-weight Americans, the opposite is true. While they may have a "healthy" BMI and look skinny on the outside, on the inside, they're a mess. Dr. Neil Ruderman first recognized these individuals 33 years ago, labeling them "metabolically-obese, normal-weight." Today, they're more casually described as "skinny-fat." Skinny-fat people generally have all the hallmark health problems associated with obesity -- high blood pressure, increased levels of LDL cholesterol, insulin resistance -- without overtly looking the part.

In 1981, Ruderman lamented that these individuals would be "difficult to detect by any criteria." Thirty-three years later, doctors can see the telltale signs of "skinny-fat" from blood tests taken at a health check-up and a glancing physical exam -- a bulging belly is a key clue. For a clearer view of the condition, they can stick individuals in an MRI scanner. What they see -- displayed in the image above -- are layers of fat coating the internal organs, gumming up the works.

Alarmingly, being skinny-fat may be more dangerous than just being fat. A study published earlier this year found that people with a normal weight and high body fat have a significantly higher risk of death from obesity-related diseases than any other group.

While the health risks of skinny-fat may be worse than those associated with obesity, the solutions are mostly the same. Skinny-fat individuals don't necessarily need to eat less, but they should consider reorganizing their diet, particularly limiting the intake of sugary drinks, fried foods, and sources of simple carbohydrates like white bread, snack chips, and candy. Even more important is to begin habitually exercising. Working out doesn't just serve to trim your outside; it also trains your insides.

"Getting more exercise broadly and positively influences major body systems and organs and consequently contributes to make someone metabolically healthier," said Dr. Francisco Ortega, an associate professor at the University of Granada in Spain.

And you don't even need to pick up sumo wrestling. Regular walking is a great start. Running, playing sports, swimming, and weight-training are even better.

(Image: Wikimedia Commons)

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