Covid-induced lifestyle wreaks havoc as fat hiding behind thin frame becomes a norm

Covid-induced lifestyle wreaks havoc

Here’s a strong reason not to be lulled by the “right” body mass index (BMI): After Covid-19, there has been an increasing tendency of “thin-fat” phenotype among the Indian population.

NEW DELHI: Here’s a strong reason not to be lulled by the “right” body mass index (BMI): After Covid-19, there has been an increasing tendency of “thin-fat” phenotype among the Indian population.

“While Covid has prompted dietary habit changes among people, the lack of exercise on account of staying home has extended even after the pandemic. The BMI of Indians is lower compared with the rest of the Asian population and also the Europeans. But we have a higher proportion of fat with the same BMI. So, while by appearance, you may be thin, going by the body mass ratio, you could be fat. Most of this fat is stored near the abdomen; so, there is central obesity,” Dr Naval Vikram, professor, department of medicine, Metabolic Research Group, said.

Thin fat is defined as the presence of an increased body fat percentage in an individual with a normal body mass index. A thin-fat phenotype occurs when fat is added to an already thin frame. It is characterised by a smaller body frame, lower muscle mass and higher body fat percentage, particularly in the abdominal region.
Dr Parinita Kaur, senior consultant internal medicine, Aakash Hospital, added: “This condition is also called normal weight obesity or metabolic obesity. Such people are metabolically unhealthy. Although they may have normal weight as far as the BMI is concerned, they have a disproportionately high body fat percentage. Throughout the world, the normal BMI is considered to be between 18.5 and 24.9. But for Indian ethnicity, the cutoff is 18.5 to 22.9. It is important to know about thin fat because one may appear to have a normal weight, but can have a high-fat percentage.”
Post-Covid, sedentary lifestyle is one of the prime causes for the surge in thin-fat phenotype. Several other factors, such as genes, environment, behaviour and food habits, are responsible for obesity. Alterations in the timing of food intake and sleep-wake cycle disturb the diurnal rhythm of the body, which also contributes to obesity.

Thin fat is a matter of major health concern. It increases the risk of several chronic diseases, such as diabetes, high blood pressure, heart disease, certain types of cancers, polycystic ovarian disease and infertility. Thin-fat obesity is even linked to other complications, such as metabolic syndrome, type-II diabetes and cardiovascular diseases. It has a huge negative impact on one’s mental health also, as evidenced by an increase in prevalence of psychiatric disorders in individuals with obesity. These individuals often face stigma, discrimination and social isolation and have low self-esteem, which further aggravates their mental health.
“Muscles are crucial for metabolism as they are responsible for using the glucose the most. If fat is concentrated in the abdomen, then more fatty acids are released and go to the liver. It increases resistance to the action of the insulin produced by the body, and insulin acts mainly through muscle. More fat with a lower BMI leads to insulin resistance. This leads to diabetes, which then causes heart disease and blood vessel blockages over time,” Dr Vikram noted.

As it is a complex disease, the management of thin-fat obesity requires a comprehensive approach. Unlike other diseases, one treatment is not suitable for all and therapy needs to be individualised. Lifestyle management forms the corner stone of management with changes in diet and physical activity. Cognitive behavioural therapy is helpful in overcoming bad habits and food cravings, along with acquiring good habits. Exercise plays an important role in the management of obesity.

“Those with a faster metabolism rate can burn this type of fat easily. But because of genetics and gender (women), it is not always possible to burn the fat. One has to concentrate on muscle-building exercise, and not just cardio. Strength-building exercise has to be done and protein intake increased. When muscle mass increases, the metabolism also increases and when metabolism increases, the fat goes away,” said Dr Arun Prasad, senior consultant, surgical gastroenterology and bariatric surgery, Indraprastha Hospital.