Being Normal Weight With Extra Belly Fat Is Deadlier Than Being Obese

The type and location of fat may be a better indicator of heart health and longevity than the number on the scale.

You may want to take in a deep breath — and suck in your gut — for this one.

People with a normal BMI who carry extra fat around the middle have a higher risk of dying early than those who are overweight or obese but have normal body fat distribution, according to November 2015 research published in Annals of Internal Medicine.

In the first study to focus on the comparison of people with normal BMIs and central obesity – aka excessive belly fat — and people with overweight or obese BMIs, researchers analyzed the waist-to-hip ratios of more than 15,000 adults and found that "normal-weight adults with central obesity have the worst long-term survival compared with any group, regardless of BMI," according to a press release.

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In short: Your health depends on more than just the number on the scale.

"What this study highlights is that body composition matters," says Shanna Levine, MD, instructor of general internal medicine at the Icahn School of Medicine at Mount Sinai in New York City.

It's well established that excess visceral fat – aka the deeper layer of belly fat that hugs your organs – is a risk factor for metabolic syndrome, which can increase your risk of developing heart disease, stroke, and diabetes, but now it looks like it also increases your risk for total and cardiovascular mortality.

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But this research doesn't mean that overweight and obese people with more evenly distributed body fat should abandon their goals of getting to a healthier weight.

"Until we are looking at studies that control for specific factors, like muscle mass amounts, waist circumference, etc., you can't generalize," says Dr. Levine. "Instead, you should follow the key principles of health: eat well, maintain a normal weight, and move. We know excess abdomen fat leads to poor health outcomes, but don't focus solely on it or numbers. Focus on how your clothes fit and how you feel."

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