Are You Skinny Fat? Why It Can Be Worse Than Being Obese
Save “Fat” is an enormous issue in this country. According to the Centers for Disease Control (CDC), 35% of Americans can be classified as obese and a whopping 70% of Americans are overweight. Being overweight or obese can increase your risk for a multitude of additional health problems including stroke, some cancers, heart disease, and depression. It can also seriously diminish quality of life. But what about “skinny fat?” It may frighten you to hear that we can suffer all these problems, even if we’re “normal” weight or underweight. In fact, about 25% of the remaining 30 percent of those who don’t fall into the overweight or obese categories are what I call “skinny fat,” and they can still have diabesity- a term I coined to describe the spectrum of imbalance ranging from mild insulin resistance to pre-diabetes to full-blown type 2 diabetes. Health repercussions for the “skinny fat” can be even more dangerous than being overweight or obese. You might be wondering how this is even possible. Let me explain this phenomenon. The “TOFI” Epidemic We all know some people who can eat whatever they want and stay thin. You might even be jealous that they can eat as much junk food and dessert as they want, but never have to worry about their weight. Unfortunately, the health consequences for these people might be a lot worse than you could imagine. Many of these people are “skinny fat,” a term that refers to people who do not have enough muscle tone, or are “underlean” instead of “overweight” and have extra visceral fat around the abdomen. In other words, these people are thin on the outside and fat on the inside, or TOFI. Dr. Jimmy Bell coined this acronym to describe people who are thin but unhealthy. These skinny-fat people have a low bo Continue reading >>
Thin Type 2s?
We’ve all read about people with Type 1 climbing mountains, dancing ballet, or playing professional football. But people with Type 2 are thought by many to be overweight and sedentary. Last week I learned different. It’s an interesting story. You occasionally hear from diabetes educators about “thin Type 2s,” but for a long time, I thought they didn’t really exist. I thought they were misdiagnosed Type 1s or 1.5s. I figured they had either LADA (Latent Autoimmune Diabetes of Adults) or MODY (Maturity Onset of Diabetes of the Young). My reasoning went like this: Type 2 diabetes is driven by insulin resistance. Insulin resistance has many causes, but the main ones are physical inactivity and stress. So how could a very active person develop Type 2? Well, now I know. If you have the right genes, stress can drive even a very active person to Type 2 all by itself. Last week, I spoke at a support group for people with Type 2. Two of the group members, one man and one woman, were not only thin, but very active. The man kept tapping his foot and rocking his legs back and forth. The woman kept moving around in her chair. Both the man and the woman talked of exercising a great deal. In my experience, people with Type 2 don’t move as much as these two do. They don’t fidget. They conserve energy. (Readers — has that been your experience?) Saving energy is vital to survival where life is physically demanding and food is scarce. In a culture like ours, where food is plentiful and physical activity is discouraged, being an energy-saver can contribute to health problems, including Type 2 diabetes. Solving the puzzle At first, I thought, “You guys aren’t really Type 2.” In the past, I had actually helped a number of fit 1.5s by diagnosing them (over the phone!) aft Continue reading >>
One-third Of Slim American Adults Have Pre-diabetes
Among normal-weight individuals, those who were inactive were more likely to have an A1C level of 5.7 or higher, which is considered to be pre-diabetic Among all the normal-weight inactive participants (aged 20 and over), about one-quarter were either pre-diabetic or diabetic When only those inactive people aged 40 and over were analyzed, the percentage rose to 40 percent Inactivity increases your risk of pre-diabetes even if you’re not overweight or obese By Dr. Mercola It's often assumed that in order to develop type 2 diabetes, you have to be overweight. While it's true that excess weight is clearly associated with insulin resistance and diabetes, it's the insulin resistance — not necessarily the weight gain — that drives the disease. As such, many people with a healthy weight are not metabolically healthy, putting them at risk of diseases like type 2 diabetes — even without being overweight or obese. One of the greatest risk factors, according to University of Florida researchers, is actually inactivity, which drives up your risk of pre-diabetes regardless of your weight. Inactivity Is Associated With Pre-Diabetes, Even if You're a Healthy Weight If you were looking for motivation to get moving, this study, published in the American Journal of Preventive Medicine, is as good as it gets.1 In a survey of more than 1,100 healthy-weight individuals, those who were inactive (physically active for less than 30 minutes per week) were more likely to have an A1C level of 5.7 or higher, which is considered to be pre-diabetic. Among all the inactive participants (aged 20 and over), about one-quarter were either pre-diabetic or diabetic. When only those inactive people aged 40 and over were analyzed, the percentage rose to 40 percent. The researchers suggested that peop Continue reading >>
Think Skinny People Don’t Get Type 2 Diabetes? Think Again.
In the last article we discussed the complex relationship between body weight and type 2 diabetes (T2DM). We learned that although obesity is strongly associated with T2DM, a subset of “metabolically healthy obese” (MHO) people have normal blood sugar and insulin sensitivity and don’t ever develop diabetes. In this article we’re going to talk about the mirror reflection of the MHO: the “metabolically unhealthy nonobese” (MUN). These are lean people with either full-fledged type 2 diabetes or some metabolic dysfunction, such as insulin resistance. You might even be surprised to learn that skinny people can and do get T2DM. They are rarely mentioned in the media, and there isn’t much written about them in the scientific literature. Perhaps these folks have been overlooked because type 2 diabetes has been historically viewed as a disease of gluttony and sloth, a self-inflicted outcome of eating too much and not and not exercising enough. But the very existence of the MUN phenotype proves that there’s more to T2DM than overeating and a sedentary lifestyle. Remember that one in three type 2 diabetics are undiagnosed. It’s possible that a significant number of these people that are lean. They don’t suspect they might have T2DM because they’re under the impression that it’s not a condition that affects thin people. This is one of the biggest dangers of the myth that “only fat people get diabetes”. It’s well-known that high blood sugar can precede the development of T2DM for as long as ten years. It is during this time that many of the complications associated with diabetes – nerve damage, retinal changes, and early signs of kidney deterioration – begin to develop. This is why it’s just as important for lean people to maintain healthy blood s Continue reading >>
Type 1 Diabetes
Type 1 diabetes (also known as insulin-dependent diabetes mellitus — IDDM — or juvenile diabetes) occurs when the pancreas does not make enough insulin because the cells that produce insulin have been destroyed by the immune system. Without insulin, sugar is not able to move into the cells. Sugar therefore remains in the blood, leading to hyperglycemia (high blood sugar). Type 1 is the most common type of diabetes found in children and young adults. It is now believed that diabetes develops gradually, over many months or even years. The immune system destroys more and more insulin-producing (beta) cells in the pancreas over time, until the diagnosis of type 1 diabetes is made. Who gets type 1 diabetes? Type 1 diabetes is seen most often in children and young adults, although the disease can occur at any age. People with Type 1 disease are often thin to normal weight and often lose weight prior to diagnosis. Type 1 diabetes accounts for about 5-10% of all diagnosed cases of diabetes. Risk factors for type 1 diabetes: Any combination of the following factors may put people at a higher risk for type 1 diabetes: Self-allergy (autoimmunity): The immune system usually protects us from disease, but in the case of type 1 diabetes, the immune system turns against the cells in the pancreas that produce insulin (beta cells). If you have any type of autoimmune disease, your risk of developing diabetes increases. Doctors can test for diabetes antibodies, specifically one called GAD65. Measuring this antibody early in the disease can help your medical team determine if you have type 1 or type 2 diabetes. Genes: People with type 1 diabetes are more likely to have inherited genes putting them at risk. Over 50% of those diagnosed with type 1 diabetes also have a close relative with Continue reading >>
Thin People Get Diabetes, Too
Nearly 20% of people with this disease are not overweight… It’s widely known that type 2 diabetes tends to strike people who are overweight. In fact, about 85% of people with diabetes are carrying extra pounds. But what about those who aren’t overweight? A popular misconception: It’s commonly believed—even by many doctors—that lean and normal-weight people don’t have to worry about diabetes. The truth is, you can develop diabetes regardless of your weight. An unexpected risk: For those who have this “hidden” form of diabetes, recent research is now showing that they are at even greater risk of dying than those who are overweight and have the disease. What you need to know about diabetes—no matter what you weigh… No one knows exactly why some people who are not overweight develop diabetes. There’s some speculation that certain people are genetically primed for their insulin to not function properly, leading to diabetes despite their weight. Still, because diabetes is so closely linked to being overweight, even researchers were surprised by the results of a recent analysis of 2,600 people with type 2 diabetes who were tracked for up to 15 years. Startling new finding: Among these people with diabetes, those who were of normal weight at the time of diagnosis were twice as likely to die of non–heart-related causes, primarily cancer, during the study period as those who were overweight or obese.* The normal-weight people were also more likely to die of cardiovascular disease, but there weren’t enough heart-related events to make that finding statistically significant. Possible reasons for the higher death rates among normal-weight people with diabetes… The so-called obesity paradox. Even though overweight and obese people have a higher risk of d Continue reading >>
10 Diabetes Myths Debunked
Is it really true that eating sugar causes diabetes? And who says you can't eat sugar if you already have the disease? Read on to see those and other myths debunked. 1. Myth: You have to be overweight to develop diabetes; thin people don't get the disease. Fact: There's no doubt that obesity is a major contributor to type 2 diabetes. Genetics also plays a role. But blood sugar can creep up with age, even in skinny people. Our experts recommend that people ages 45 and older have their blood sugar checked every three years. Start earlier if you are overweight and experience symptoms. It's also a good idea if you have one or more additional risk factors, including being sedentary; being of non-Caucasian ancestry; having a family history of diabetes or a personal history of gestational diabetes, heart disease, or polycystic ovary syndrome; or having high blood pressure, cholesterol, or triglyceride levels. 2. Myth: You can get diabetes from eating too much sugar. Fact: While continually overdosing on sweets can help trigger diabetes in someone with prediabetes or another predisposition, it is not a direct cause of it (although the sweet stuff can make you pack on pounds, a major risk factor). People with type 2 diabetes gradually develop resistance to insulin, the hormone responsible for helping to convert blood sugar into energy, and diabetes develops when the pancreas can no longer keep up with the increased demand. In the less common type 1 form, the body's immune system attacks insulin-producing cells in the pancreas. 3. Myth: You'll know if your blood sugar is too high because you'll develop telltale symptoms. Fact: Not necessarily. Slightly elevated blood sugar usually doesn't trigger symptoms. And even in people with moderately elevated blood sugar, the symptoms may Continue reading >>
Are You ‘skinny Fat’?
The common wisdom is that if you’re overweight you're unhealthy, and if you’re thin, you're healthy. New research says otherwise. On the outside, you’re an average Joe with a normal build and a pant size that’s readily available. But on the inside – it’s a different story. The term "skinny fat” is a phrase used to describe people who look fit and healthy on the surface yet, due to a lack of exercise or poor diet, have a slew of health problems brewing beneath it. One study published in the Journal of the American Medical Association found nearly one in four skinny people have pre-diabetes and are “metabolically obese.” In other words, are skinny fat. Here’s the thing: diabetes is the fastest-growing chronic health problem plaguing Aussies, yet many of us wouldn’t know how to spot if we were at risk of the deadly disease. One Australian is diagnosed with diabetes every five minutes. Of those, 85-95 per cent will be diagnosed with type 2, a condition that’s both deadly and preventable. Sof Andrikopoulos, CEO of the Australian Diabetes Society, describes type 1 and type 2 diabetes as diseases of the pancreas, in which the pancreas is unable to secrete enough insulin to regulate the glucose levels in our blood. “With type 1, the immune system actually kills the cells that produce insulin so there’s a complete deficiency. With type 2, the insulin-producing cells don’t work efficiently so there’s a relative deficiency.” Type 2 used to typically affect men and women who were over 55. That’s all changed now, Andrikopoulos says: “When I started in diabetes research 25 years ago, you had to be over 55 to get type 2 but now we’re seeing it in young adults, adolescents and even in children under 10. It all comes down to our lifestyle – the Continue reading >>
11 Ways To Gain Weight If You Have Diabetes
Although diabetes is often associated with being overweight, especially type 2 diabetes, it’s a myth that everyone with diabetes has a high body mass index (BMI). Some people have trouble gaining weight. In fact, unexplained or unintentional weight loss can be a symptom of undiagnosed diabetes. Issues with weight management center around insulin, a hormone produced by your pancreas. People with diabetes are unable to use or produce enough insulin to transport excess sugar out of their blood and into their cells, where it can be used as energy. This can cause your body to burn its existing fat stores and muscle tissue in order to supply your cells with energy. If your sugar levels are constantly in flux, your body will continue to chip away at its fat stores, resulting in weight loss. Diabetes food plans are often geared toward helping people lose, rather than gain, weight. This can make it harder to figure out how to gain weight in a healthy way. Before trying the tips below, talk with your doctor or dietician. They can help you set the right diet and exercise goals for you, as well as answer any questions you may have. There are many apps available to help you manage your condition and make the right food choices. Look for apps that help you track blood sugar and BMI. Some options include: GlucOracle: This glucose forecasting app uses crowdsourcing to analyze the estimated amount of carbohydrates, protein, fat, calories, and fiber in each meal. It also predicts what your glucose level will be after eating. SuperTracker: This app helps you gain weight by providing comprehensive nutritional information on over 8,000 food items. It also tracks your nutritional targets, diet, and activity levels against your goals. If these don’t appeal to you, we’ve also rounded up Continue reading >>
How A Thin Diabetic Reversed Her Type 2 Diabetes
I received a letter from reader Sarah, who has successfully used low-carbohydrate high-fat diets and intermittent fasting to reverse her type 2 diabetes. Interestingly, she is not particularly overweight as measured by body mass index, yet still suffered from T2D. At her heaviest, she only had a BMI of 24.9, which puts her in the ‘normal’ range. She writes: The letter I immigrated to US from P.R. China in the end of 1998 when I was 31 years old; I weighed about 55 kg (121 lbs). While I was in China, I lived thousands of miles away from my family, so I had sort of an intermittent fasting life style from age 19 to 31 years old. The meals in China were mostly vegetables and very little protein. I had an annual physical check up every year, but was never told of any abnormal blood results. After I immigrated to the U.S., my lifestyle suddenly changed from one meal per day to three meals consisting of mainly grains with little fat and protein. I gained about 25 pounds (11 kg) in a couple of years, my weight did not continue going up. My heaviest was about 145 pounds (66 kg). When I was diagnosed with diabetes in Dec 2004: Weight: 142 pounds (64 kg) Height: 5 feet 4 inches (163 cm) HbA1c: 9.4 FG: 214 I was told to exercise, so I started yoga shortly after my diagnose. I lost about 10 pounds (5 kg) and 2 inches (5 cm) from my waist but still required metformin. In the spring of 2005, I relocated to Galveston from Houston because of my work as an engineer. My endocrinologist sent me to a nutritionist who measured my after meal glucose in her office, it was near 200 mg/dl (11.1 mmol/l) three hours after lunch which was only one low-fat pita bread. I was devastated, my previous family doctor always told me that if I exercise daily, my blood sugar will come down to normal, so Continue reading >>
Why Thin People Get Diabetes
If you think only overweight men need to worry about diabetes, wake up. One in five normal-weight adults now has prediabetes, up 8 percent from 1994, finds new research from the University of Florida. Among adults over age 45 with BMIs under 25, one in three has high blood sugar, a double-digit jump in two decades. Left untreated, up to 30 percent of people with prediabetes will develop full-blown type 2 within five years. Why the sharp rise in this condition? The abundance of nutrient-void, sugar-packed processed foods is likely having some effect. However, “our increasingly sedentary lifestyles are playing a huge role,” says lead researcher Arch Mainous. “Many people now sit in front of a computer all day and get only minimal, if any, leisure-time exercise. They think that as long as their BMI is under 25, they’re healthy. But the scale gives a false sense of health.” According to Mainous, skimping on exercise is so metabolically harmful because it leads to a higher proportion of body fat than lean muscle mass. He says people with very little lean muscle tend to have low grip strength — and past research has linked low grip strength to heightened risk of prediabetes and diabetes. The easiest way to tell whether you’re potentially in trouble? “Just look in the mirror,” Mainous says. “If you look too soft, you are too soft.” When it comes to high blood sugar, surprisingly, total-body lean muscle mass matters more than even waist circumference, which is often blamed for metabolic health issues. “Many think metabolic syndrome is all about abdominal obesity,” Mainous says. “But we looked at waist circumference in our study, and it did not go up. Incidence of prediabetes did, so I don’t think abdominal obesity is the key.” Mainous believes do Continue reading >>
Type 2 Diabetes In Women: Young, Slim, And Diabetic
Stephanie Yi, 29, had a body most women would kill for. She never had to work hard to maintain her long-limbed, flat-bellied frame—weekend hikes near her northern California home and lots of spinach salads did the trick. She could easily afford to indulge her sweet tooth with the occasional buttery, sugary snack. At 5'7" and 120 pounds, she had, she figured, hit the good-genes jackpot. But everything changed two years ago, when a crippling fatigue left her sidelined from college classes. Listless, she dragged herself to a doctor, who suspected a thyroid imbalance. A blood test and a few days later, she received the alarming results: Her thyroid was fine; her blood sugar levels were not. She was prediabetic and on the cusp of developing type 2. Stephanie was stunned. Of course, she'd heard diabetes was a health crisis. (At last count, 26 million Americans had the disease, according to the Centers for Disease Control and Prevention.) But weren't type 2 diabetics fat, sedentary, and on junk-food-and-soda diets? Stephanie hadn't been to a drive-through in ages; she didn't touch meat. Yet, somehow, she'd gotten an illness most slim women dodge. A Growing Threat The CDC estimates that one in nine adults has diabetes and, if current trends continue, one in three will be diabetic by the year 2050. For decades, typical type 2 patients were close to what Stephanie pictured: heavy and inactive. They were also older, often receiving a diagnosis in middle age or beyond. But while such type 2 cases continue to skyrocket, there has been a disturbing increase in a much younger set. The number of diabetes-related hospitalizations among people in their thirties has doubled in the past decade, with women 1.3 times more likely to be admitted than men. Perhaps even more troubling is the e Continue reading >>
Ask An Expert: Can A Young, Healthy, Active Adult Get Diabetes?
Q: Can an active, 32-year-old Caucasian female who eats well and who does not suffer from obesity, high blood pressure or high cholesterol be diagnosed with diabetes or pre-diabetes? If so, how common is this? Answer from Susanna Reiner, R.N., B.S.N., diabetes nurse educator, Providence Diabetes Education: Yes — even though a healthy diet, weight and lifestyle greatly reduce the chances of developing diabetes, there is still a small chance that the woman you described could be diagnosed with pre-diabetes or diabetes due to risk factors beyond her control. It’s relatively uncommon, but it does happen. Fortunately, her healthy lifestyle will be an asset to her. If the woman in question is diagnosed with pre-diabetes, then staying physically active, maintaining a low-stress lifestyle and following a well-balanced diet will help her prevent or delay the diagnosis of type 2 diabetes, according to the Diabetes Prevention Program. If she is diagnosed with diabetes, she’ll have a much better chance of preventing complications related to uncontrolled diabetes if she continues to follow her healthy habits. What could cause diabetes in such a young, otherwise healthy adult? Let’s first consider type 2 diabetes, which accounts for 90 to 95 percent of all cases of diabetes in the United States according to the National Diabetes Fact Sheet. Some of the most common risk factors for type 2 diabetes don’t appear to apply to the woman you’ve described. These include the following: Obesity, particularly around the waistline (associated with 90 percent of people who have type 2 diabetes, according to the World Health Organization) Certain non-Caucasian ethnic backgrounds (African-Americans, Native Americans, Hispanic/Latino Americans, Asian Americans and Pacific Islanders are a Continue reading >>
How Weed Keeps You Skinny: What Researchers Say About Marijuana, Weight, And Diabetes
No, we’re not joking. Weed may be notorious for the munchies, late night trips to the drive-through, and many an hour stuck on the sofa, but researchers are beginning to wonder: why aren’t more cannabis users suffering from obesity? We’re about to give you all you need to know about how weed keeps you skinny: what researchers say about marijuana, weight, and diabetes. Photo Credit: Pixabay Turns out, regular marijuana consumers have lower BMIs, a reduced risk of obesity, and perhaps even an easier time managing their weight. Interesting, right? Here’s the scoop on how it all works: The Perks of Being A Cannabis Consumer Photo Credit: Flickr Smaller Waistlines Scientists at the University of Nebraska, the Harvard School of Public Health, and Beth Israel Deaconess Medical Center found that marijuana users had a smaller waist circumference than those who had never used cannabis. Another 2011 study published in the American Journal of Epidemiology surveyed over 52,000 participants and found that overall, rates of obesity are about one-third lower among cannabis users. A bit of a conundrum, since on average, weed lovers consume around 600 more calories per day. More Good Cholesterol A study published last year in Obesity measured data from over 700 members of Canada’s Inuit community and found that on average, regular cannabis users had increased levels of High-Density Lipoprotein Cholesterol HDL-C (good cholesterol) and slightly lower levels of Low-Density Lipoprotein Cholesterol LDL-C (bad cholesterol). Jump-Started Metabolism Turns out, the active component of cannabis may help kick your metabolism into overdrive. Tetrahydrocannabinol (THC) stimulates the production of a little hormone called ghrelin. Ghrelin is well known to the science community as a potent ap Continue reading >>
5 Signs You Might Be 'skinny Fat'
When it comes to your health, the mirror and the scale tell only part of the story. If you’ve always been a normal weight without having to try too hard, you may consider yourself lucky. But the mirror and the scale only tell part of the story: You can look great in a bikini or have a body-mass index (BMI) in the normal range, but if you don’t take care of yourself, you could be just as unhealthy as an obese person. This phenomena—sometimes known as skinny-fat, or “normal-weight obesity”—may affect up to one-fourth of normal weight people, according to one 2008 study. “They look healthy, but when we check them out they have high levels of body fat and inflammation,” says Ishwarlal Jialal, MD, director of the Laboratory for Atherosclerosis and Metabolic Research at UC Davis Health System. “They’re at high risk for diabetes and cardiovascular problems, but you wouldn’t know it from their appearance.” Getting your blood pressure, cholesterol, and blood sugar levels checked is the only way to know for sure how healthy you are metabolically. But there are some warning signs that may help you determine whether you’re at risk for normal-weight obesity. If these characteristics apply to you, talk to your doctor about how you can make sure you’re physically fit, both inside and out. You have a muffin top Even if you’re a healthy weight overall, sporting a spare tire can be dangerous. In fact, a recent study in the Annals of Internal Medicine found that normal-weight people with excess fat around their middle had an even higher risk of dying early than their overweight or obese peers. “Fat around the middle is worse than fat anywhere else,” says Dr. Jialal. “It’s where the damage starts in terms of insulin resistance and inflammatory proteins Continue reading >>