Looking Fit May Not Mean You’re Metabolically Healthy, Doctor Explains
Looking fit may not always reflect underlying metabolic health.
A slim appearance does not always indicate good metabolic health, as body weight and metabolic health can be influenced by different factors. People with a normal body mass index (BMI) can still have insulin resistance, high blood pressure, abnormal cholesterol or triglyceride levels, elevated blood sugar, fatty liver or increased cardiovascular risk, according to Dr Pankaj Khatana, senior consultant, internal medicine, Marengo Asia Hospitals, Gurugram.
Dr Khatana explained that the distribution of body fat can be more important than body weight alone when assessing metabolic health. Visceral fat, which accumulates around internal organs, and fat stored in organs such as the liver can affect insulin sensitivity and contribute to changes in cholesterol and triglyceride levels. This means that some people with a normal BMI may still carry metabolic risk despite appearing lean.
Lifestyle factors can also influence metabolic health regardless of a person’s size or weight. Physical inactivity, an unhealthy diet, inadequate sleep, smoking and excessive alcohol consumption may contribute to metabolic problems. Genetics and age can also affect how the body stores and processes fat, making body weight alone an incomplete measure of overall health.
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For a clearer assessment, Dr Khatana recommended looking beyond BMI and considering indicators such as waist circumference, blood pressure, fasting blood glucose or HbA1c, and a lipid profile. Depending on an individual’s circumstances, doctors may also recommend liver tests or an evaluation for fatty liver. These measures can help identify metabolic concerns that may not be apparent from physical appearance alone.
Dr Khatana stressed that being thin should not automatically be considered a sign of good health. Regular physical activity, a balanced diet, adequate sleep and maintaining healthy blood pressure, blood sugar and cholesterol levels are important components of metabolic health. The number displayed on a weighing scale provides only one part of the overall health picture.
The concept of metabolic health therefore highlights why appearance and health should not be treated as interchangeable. A person’s weight can provide useful information, but it does not by itself reveal how the body is managing blood sugar, fats or blood pressure. A broader assessment, combined with healthy lifestyle habits and appropriate medical checks, can provide a more meaningful picture of metabolic wellbeing.
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