Are You "Skinny Fat?"

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Can you be slim and fat at the same time? In a word, yes. Despite being a healthy weight and appearance, if you've got extra body fat and tucked-away jiggle areas, you may be at risk for a host of health problems associated with obesity. Moreover, you aren't alone: As many as 30 million Americans, or 10 percent of the population, may be skinny fat, or "normal weight obese," according to a recent study by the Mayo Clinic that is redefining how to accurately measure health. "Normal weight obesity changes your cholesterol and blood sugar and metabolic abnormalities," says cardiologist Francisco Lopez-Jimenez, MD, the lead researcher of the study. "Over time, this can shut your body down."

So what's a gal to do? Follow the Oxygen lifestyle of weightlifting, cardio training and clean eating to turn your skinny fat into lean, strong and healthy muscle, and keep your fitness goals on track.

The Skinny on "Normal Weight Obesity"

For years, body mass index, or BMI, was the gold standard in determining body fat. But as the Mayo Clinic study (published in the European Heart Journal late last year) points out, BMI often fails to differentiate between high body fat and lean muscle mass.

In fact, after analyzing nearly 6,200 men and women, Lopez-Jimenez and his colleagues found that about one third of American adults considered to have normal body weight actually have high body-fat percentages. Lopez-Jimenez compares the phenomenon to a house that looks great on the outside, with fresh paint and flower boxes, but whose shoddy construction means it's falling apart on the inside.

The bottom line? Skinny-fat women are not only less fit than they think, they're also at risk for the same problems as overweight and obese people, including heart disease, diabetes and death.

The good news is that trainers, physicians and even fashion directors are now realizing that thinness isn't an indicator of good health. (In 2006, Madrid banned too-skinny models from its fashion-show runways.) And it's surprisingly simple to figure out if you might be skinny fat. While the most accurate measurement of normal-weight obesity is through water immersion, according to Lopez-Jimenez, measuring your waist circumference is a good technique for determining if you have central obesity.

From Skinny Fat to a Lean Body

Regular progressive strength training and clean eating is the solution to skinny fat. In addition, you need to get your heart pumping. For cardio training, active women need at least 30 minutes of moderate-intensity activity (such as a brisk walk) five days per week in order to avoid normal weight obesity, says Steven Blair, a professor of exercise science and epidemiology/biostatistics at the University of South Carolina and a former president of the American College of Sports Medicine. That may not sound like much if you're used to hitting the gym regularly, but it gives you at least a minimum to aim for. "Cardio training expends a high number of calories and therefore fat," says owner of Northwest Personal Training Sherri McMillan of Vancouver, Washington. "It also raises your anaerobic threshold, allowing you to work harder, faster and longer - therefore expending more calories and fat."

After a couple of months of base conditioning, ramp up the calorie- and fat-burning potential of your workout - you'll need to add high-intensity intervals two days per week, McMillan says. Start with 30 seconds at 80 percent of your max heart rate. Once you recover, repeat for another 30 seconds. Build up to two-minute high-intensity intervals.

A clean diet is the next component to avoiding normal weight obesity. Even if you're not visibly gaining weight, over consumption of processed foods and alcohol is like putting poor-quality gas in your car, says Bonnie Taub-Dix, a registered dietitian in New York City and author of Read It Before You Eat It. "You can shine the outside and try to make that car look beautiful," she says, "but it won't function as efficiently."

To keep yourself on track, add vegetables to anything you can, suggests Taub-Dix, and stick only with mono- and polyunsaturated fats to avoid extra calories and to promote heart health. If you're always on the go and looking for a quick and healthy salad dressing but can't make one yourself, she suggests buying a pre-made dressing at the grocery store, taking it home, shaking it up, pouring half of it into a separate jar and filling the other half of the jar with good-quality vinegar.

Lift Weights, Lower Body Fat

Cardio and clean eating won't do it alone - to steer clear of the skinny-fat state, you also need to incorporate strength training. "Normal weight obesity is all about having extra fat and limited muscle mass," says Lopez-Jimenez. "With strength training, you can build up some muscle mass and burn fat at the same time."

Numerous studies have shown that weight training is the only way to drop body fat and change body composition. In a recent issue of Cell Metabolism, researchers from Boston University School of Medicine reported that building up type 2 muscle fibers by lifting weights reduces overall body fat and improves metabolic functioning. To burn the most calories and fat, perform multi-joint movements such as squats, lunges, step-ups, chin-ups and presses, McMillan says. "At the end of every set you should hit momentary muscle fatigue, so that you can't do one more rep with good form," she says. "Every set should finish with a good effort - if not, there's not enough stimulus to experience good results."

Belly Fat: An Indicator of Skinny Fat

It's not only how much body fat you have, but also where you store fat on your body that helps indicate your overall health and fitness. And your midsection is just about the most problematic place for extra pounds. Harvard Medical School researchers, among others, have found visceral fat - deep inside the abdomen, surrounding the organs - linked to heart disease, diabetes and other serious health problems.

Measuring your waist is the easiest and cheapest way to check your belly fat. Do it first thing in the morning. Without pulling too tightly, wrap the measuring tape completely around your waist so that it sits right above your navel. Don't suck in your stomach, but breathe naturally. Anything greater than 33 inches could be a health risk, according to Harvard researchers. And fit, active women should keep their waist measurements much lower than that.

Shed Your Skinny Fat

Get in the best shape - and health - of your life with these expert- and research-backed strategies:

  1. "Go with weights," says Robert Sallis, MD, past president of the American College of Sports Medicine and co-director of the Kaiser Permanente Sports Medicine Fellowship Program in Fontana, California. Strength training boosts your metabolism for longer bouts of fat loss.
  2. Practice high-intensity interval training, says fitness trainer Sherri McMillan, an American Council on Exercise spokesperson and the author of Go For Fit: The Winning Way to Fat Loss (Raincoast Books, 2009). A study by Laval University in Quebec found that intervals can burn nine times as much fat as regular steady-state cardio exercise.
  3. Get up and move around. New guidelines from the Centers for Disease Control and Prevention recommend that Americans not only practice cardio and strength training, but also add more activity to each day. Pace while you talk on the phone, schedule "stand-up" meetings and take small walks around the office every 15 minutes.

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