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What is 'skinny fat': A Singaporean aesthetic doctor shares its symptoms, causes, and remedies

What is 'skinny fat': A Singaporean aesthetic doctor shares its symptoms, causes, and remedies

On the surface

Text: Emily Heng


Image: Instagram | @anyaholdstock

Not all body fat is created equal — nor are they distributed equally, as we know. From cankles to love handles, certain areas are more prone to accumulating chub depending on an individual's age, genetic makeup, and lifestyle choices (see: the notorious beer gut). And while our pizza binges often materialise in the form of a budge-proof pooch weeks after (sigh), there remains a lucky few that exhibits zero signs of weight gain despite intense gorging. What gives?

Enter: skinny fat, aka the phenomenon seemingly sweeping across Asia. According to a study conducted by medical journal, Maturitas, skinny fat is rapidly afflicting Asians of a younger age group with a lower body mass index (BMI). "To put it simply, skinny fat is fats that cannot be seen with the naked eye," Dr Lam Bee Lan, founder and director of Ageless Medical, explains. Indeed, skinny fat folks are of normal weight for their height so their scales show 'healthy' BMI — except they all have significantly higher risk of experiencing metabolic problems and death (yes, death) than any other groups of individuals. Surprised? We know we were. We get to the bottom of this with Dr Lam, addressing the symptoms, causes, and remedies to this troubling condition.

What does being skinny fat mean?
To understand skinny fat, we first have to look at the different kinds of fat out there. In layman terms, there are two types: there is subcutaneous fat, which is the fat found beneath your skin and above your muscles. Basically, they're pinchable fats, which most of us have. The second kind of fats is visceral fats, also known as intestinal fats. These are the fats found deep within the cavity surrounding your internal organs and intestines such as your liver and pancreas. People who are skinny fat — to my understanding — essentially have a lot of visceral fat.

What causes the growth of visceral fat?
Now, this one is a little tricky because how an individual accumulates fat has largely to do with genetics. If you eat a lot and don't exercise, well, of course you're going to get fat. Whether it is subcutaneous or visceral, though, really depends on your parents's body types.

What are the some of the symptoms of skinny fat?
The World Health Organisation defines visceral obesity as your abdominal circumference being above 88cm for women and 102cm for men. Another good way to tell, though, is to see if you can pinch it. Subcutaneous fat bulges. You can grab it, squeeze it, pinch it. Visceral fat, on the other hand... it's like when you look at a person's abdomen, for instance, and it looks big, right? But when you reach out to pinch it, you physically can't. The skin is very thin, and there's just no visible fat despite its protruding appearance. So, if you don't exercise regularly, eat unhealthily, and have a bit of a tummy, I'd say you are skinny fat.

What are some of the health risks with this condition?
There's been many clinical studies done that demonstrate how a high amount of visceral fats increases the risk of heart disease, stroke, high blood pressure, and diabetes. That's why it's a more "dangerous" form of fat because it's subtle. It's not visible, and you're not aware of it.

And this is particularly prevalent in Asians?
Definitely. BMI may not be an accurate way to measure the amount of visceral fat you have, though it should be noted that even our BMI cut-off for Asians is higher. According to professor Caroline Lam, a cardiologist, obesity is defined as a BMI of more than 30 when it comes to the Caucasian population. In Asia, it is 27.5 and above. It doesn't help that an Asian diet tends to be high in carbs and low in protein as with rice, noodles and dumplings.

Is there a more accurate way to measure fat?
Visceral fat? An MRI is most accurate. It emits radiation and can be costly, though, so I won't say it's a very practical option.

Are there certain foods that tend to encourage the growth of visceral fats?
Your biggest culprits would be refined sugars and carbohydrates. Think rice, white bread, and glass noodles. As for refined sugar, think desserts and drinks such as bubble tea — and Singaporeans drink so much bubble tea! It's terrible. Coconut-based food and beverages contribute to this as well.

What about foods high in sodium content?
Those don't contribute to fat growth. Salt will make you bloat and cause water retention but doesn't actually contribute to visceral fats. Salt does increase your risk of getting high blood pressure, heart problems, and such though.

Is there a way to eradicate visceral fats?
It largely boils down to diet. Cut down on your refined sugars and carbohydrates, and let your body burn the reserve stock so you can slim down naturally. You can also do exercises that increase your heart rate, such as running, swimming, cycling, hiking. This really helps burn both subcutaneous and visceral fats.

Which is easier — losing subcutaneous fat, or visceral fat?
It really depends on where the subcutaneous fat is situated. Pockets of fat on certain parts of the body are stubborn and are impossible to get rid of, such hips or Jennifer Lopez's coffee table butt. If you're exercising and controlling your diet, but just can't seem to lose the weight, then I'd recommend getting professional help. Visceral fat, on the other hand, is easy to lose as it can be possible through consistent diet and exercise.

Do treatments and machines such as Coolsculpting help?
Those tend to help more with problem areas and stubborn pockets of fat, like with the abdomen or arms. Essentially, it's like body contouring that has to still be maintained with exercise and a good diet. While they help melt or freeze pockets of fat, don't expect it to be a true weight-loss method.


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