What Does It Mean To Be “Lean Unhealthy?”

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What is “lean unhealthy?”

Ever been jealous of the people who can eat anything they want, but do not have to exercise a day in their life to avoid weight gain? Or maybe that’s you? If you have heard the term “skinny fat” you might be confused thinking it sounds like an oxymoron. This term is being thrown around to describe people who look thin but actually have more body fat than lean tissue mass (such as muscle and bone density). “Skinny fat” (also referred to as “lean unhealthy” or “thin fat”) is technically not a medical term, but many medical professionals believe this concept is a growing health concern.

“Skinny fat” or “lean unhealthy” can be better defined as Normal Weight Obesity (NWO) or when individuals have “excess body fat with adequate body mass index.” NWO occurs when body fat percentage is too high which can lead to increased risk for obesity-related health conditions such as diabetes, heart disease, abnormal cholesterol, high blood pressure, inflammation, oxidative stress, and metabolic syndrome (a combination of these conditions).

BMI isn’t enough

The easiest and most common assessment for general disease risk is historically based on calculating Body Mass Index (BMI) using just height and weight. But BMI simply tells us if we are at a normal weight for our height. It does not account for true body composition including our body fat percentage. For example, athletes who have very low body fat but have considerable muscle mass fall into a higher BMI category for their height, making it seem as if they are unhealthy.

Using body fat percentage assessments can also help determine if NWO is a concern.

The catch: you can be “lean unhealthy”

It is hard to truly define NWO with numbers like BMI (normal BMI is considered 18.5-24.9 kg/m2) because factors such as age, gender, and lifecycle phases play a major role in how much body fat is considered “normal.” With that being said, though, the Mayo Clinic estimates that over 30 million Americans have this “skinny fat” condition. Their research believes that negative health impacts of NWO are associated with women who have greater than 30% body fat and men who have greater than 20% body fat, while the American Council of Exercise considers above 32% body fat in women and above 25% in men as obesity. Why? This excess body fat produces extra hormones and stores toxins that have negative impacts on our health, especially if it falls around the abdomen close to our vital organs.

Dietitian’s Tip: Beware of falling for extreme calorie restriction and/or restrictive fad diets. These options are not the answer to “curing” NWO and can be unsafe. It’s important to work with a health professional like a Registered Dietitian to make sustainable, healthy changes that are unique to you and your body.

What you can do

With Normal Weight Obesity or “lean unhealthy” body types leading to a variety of negative health conditions, it’s important to know how to determine your body fat percentage and how to keep it on track throughout your lifecycle. If you are concerned about your metabolic weight status, follow the actionable steps below to start your journey towards a healthier, stronger you!

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Actionable Steps


Determine your body fat percentage

Not many doctor’s offices assess this but you can always ask the next time you go in for your annual physical. If it’s not available at the doc’s, find a Personal Trainer or Registered Dietitian who does body composition assessments. You can also purchase some of your own assessment tools for the home like a bioelectric impedance scale.


Compare your results to the norms

Use this chart based on gender and aim for a percentage between the “essential fat” and “acceptable” categories. Keep in mind these numbers are general recommendations for the healthy American population and your individual needs may differ from these norms.


Consider making some lifestyle changes

Do you currently fall into the Normal Weight Obesity body fat percentage category? Have no fear! Take a deep breath. Easy fix. Start making simple changes today to improve your health. Keep reading!


Start an exercise routine with a spotlight on gaining muscle

Focus on building strength and toning up. Incorporate at least two days of strength training per week on non-consecutive days to increase lean muscle mass. Try doing supersets for building max strength in minimal time.

Getting your heart rate up with cardio helps, too. Get at least 150 minutes of moderate-intensity or 75 minutes of high-intensity cardio exercise each week. High-intensity interval training (HIIT) is shown to be very beneficial for decreasing body fat (learn more about HIIT here). You can learn how to create your own workout routine here or consider working with a personal trainer for a baseline assessment and get an individualized plan.


Stay active throughout the day

Managing a healthy body composition takes more than just 60 minutes a day. The more we move throughout the day, the more we engage different muscles keeping them in an active “fat-burning” state. Especially if you have a sedentary job, you’ll want to aim to get about 5 minutes of movement every hour throughout the workday. Plan activities outside of work that keep you moving like household chores, meeting friends for a walk, or taking your dog to the dog park. Get more tips for creating movement throughout the day here.


Adjust your nutrition

Excess body fat can be a result of eating excess calories. Take a look at what you eat over the course of a normal day and adjust your calorie intake accordingly. You can use this equation to get a general idea of how many calories you need to consume each day based on your Basal Metabolic Rate (BMR, or how many calories your body burns at complete rest) and added activity level. Or work with a Registered Dietitian who can do a more accurate metabolic assessment.

Practice keeping a food log of how much you eat and compare to your estimated calorie needs. Are you over or under? You can also just use your hunger cues and other mindfulness techniques to increase awareness of how much you’re consuming. Try using these mindful eating tips. If you typically eat more energy (aka calories) than what your body expends in a day, then you’re likely gaining body fat from overeating.


Stick with it!

Stay consistent with these healthy habits and towards reaching your goals. You’re building a better body for a lifelong journey of health. Maintaining muscle mass as we age is so important for managing weight, decreasing risk for diseases, maintaining quality of life, doing normal daily activities, and feeling good! 


Read the longer version

To learn more, read these articles reviewed by our professionals: What Does it Mean to be Skinny Fat, and How Do I Tell If That’s Me, Here’s What Skinny Fat Means for Your Health, and When Thin is Fat.

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About the Author

shannon costello

Shannon Costello

Registered Dietitian Nutritionist (RDN)

Hi, I’m Shannon! I’m a Registered Dietitian Nutritionist, Culinary Coach, and Personal Trainer. After dedicating over 8 years to the corporate wellness world, I began my own nutrition practice. Chef Shannon Nutrition focuses on plant-based nutrition and culinary coaching. My passion for culinary nutrition grew when I worked as a cooking instructor for a culinary entertainment company. After several years as an instructor and event coordinator, I moved into the role of Director of Culinary Entertainment where I developed all the recipes, menus, and instructor trainings. My dietetic’s expertise helped the company expand into allergy-friendly and health conscious menus to suit all clients.
Full Bio | LinkedIn | 1:1 Coaching

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