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The truth about “skinny fat”

People often assume that if you’re skinny, you’re healthy — people only get diabetes if they’re overweight or obese. Right?

Not necessarily. No matter how thin you are, you can still get 
Type 2 diabetes

“Diabetes isn’t related to how you look,” explains
Misty Kosak, a dietitian and diabetes educator at Geisinger Community Medical Center. “Diabetes comes from insulin resistance, which causes high blood sugar. Approximately 89% of people who have diabetes are overweight or obese, which is defined as having a body mass index (BMI) of 25 kg/mor higher. There are about 27 million people in the U.S. who have diagnosed diabetes, which means roughly 3 million people who have diabetes are considered as having a normal weight.” 

One reason that thin people get diabetes? Skinny on the outside doesn’t always mean skinny on the inside. The good news is that you can fight the factors that result in Type 2 diabetes.

The problem with skinny fat

Commonly called “dad bod” or “mom bod,” “skinny fat” refers to a slender body type with small amounts of visible fat. Skinny fat people tend to have a type of fat called visceral fat. Visceral fat grows around your organs instead of under your skin, so it isn’t visible. 

If you have visceral fat, you may not look overweight, but you may have as much fat as someone who is overweight. 

“The medical term for skinny fat is MONW, which stands for metabolically obese, normal weight,” says Kosak. “People who are MONW may look healthy but are at risk for conditions like diabetes.”

Along with visceral fat, here are some other factors that can lead to diabetes in thin people. 


Your diet is an important factor in your risk for diabetes. Even if you’re thin, a poor diet can still result in visceral fat. 

“Diets high in sugar and unhealthy fats, such as saturated and trans fats, can increase the amount of fat in your body, which can lead to diabetes,” says Kosak. 


Whether it’s from heavy traffic, an upcoming deadline or a visit to the doctor, stress is all around us. When we feel stressed, our body releases a chemical called cortisol. Cortisol triggers our fight-or-flight response. 

The fight-or-flight response helped our early ancestors escape danger, but now it can lead to chronic stress, which can cause damage to the body.  

“As part of the fight-or-flight response, cortisol raises your blood sugar level,” explains Kosak. “If you experience stress for long periods of time, a chronically elevated blood sugar level may lead to weight gain, insulin resistance and diabetes.”   

Fatty liver disease

Most people have heard about fatty liver disease, especially as a result of too much alcohol. But there’s another condition called non-alcoholic fatty liver disease (NAFLD), which, as the name indicates, is not caused by overindulgence in alcohol. 

NAFLD is a predictor of diseases like Type 2 diabetes, and some experts think it may even cause diabetes. Almost 1 in every 3 adults has NAFLD, which is caused by excessive amounts of sugar — especially sugar from syrups, like high fructose corn syrup.

If you have fatty liver disease, talk to your doctor about how you can manage your risk of diabetes. 

What to do if you think you’re MONW 

Working a few small changes into your everyday habits can have a big impact on your health.

  • Eat a balanced diet. Visceral fat is very responsive to diet and exercise. Eliminating processed, fried, sugary and fatty foods can help you lose visceral fat. 
  • Incorporate movement into your day. Aim to get 150 minutes of physical activity per week.
  • Reduce your stress levels. Getting your stress levels down can lower your risk of diabetes. Try avoiding stressors, exercising more and practicing mindfulness with yoga or meditation.
  • Improve your sleep. Try for 6 to 8 hours of sleep per night. If you have trouble falling asleep or staying asleep, try cutting back on screen time before bed and making sure your bedroom is dark. Don’t consume caffeine for 8 hours before bedtime and limit alcohol before you go to sleep.  

Next steps

See if you’re eligible for Geisinger’s Fresh Food Farmacy program
Get tools and tips to manage your diabetes
Learn more about diabetes care at Geisinger