Are You a Skinny Fat Person? 10 Steps to Cure the Skinny Fat Syndrome

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The common wisdom is that if you are overweight you are unhealthy, and if you are thin, you are healthy.  But new research points to just how dangerous being skinny can be – if you are a skinny fat person that is.

The medical term for this is “MONW” or metabolically obese normal weight, which I prefer to refer to as being a skinny fat person.  It means you are under lean but over fat – not enough muscle and too much fat (especially belly fat.)  It seems it is better to be fat and fit than thin and out of shape.

While we know that 68% of American population is overweight, and that most have diabesity – being somewhere on the continuum of pre-diabetes to type 2 diabetes – the shocking news from a study published in the Journal of the American Medical Association is that nearly 1 in 4 skinny people have pre-diabetes and are “metabolically obese.”

What’s worse is that if you are a skinny fat person and get diagnosed with diabetes, you have twice the risk of death than if you are overweight when diagnosed with diabetes.  Perhaps having that extra muscle on your body from having to carry around those extra pounds protects you.

Studies on teenagers found that 37% of the skinny kids had one or more signs of pre-diabetes such as high blood pressure, high blood sugar, or high cholesterol.  Wait – almost 4 out of 10 of normal weight kids are pre-diabetic?

It is bad enough that one third of kids are overweight or obese in America, but now it appears that only about 20% of children in America are healthy – in other words 8 out of 10 children in America are overweight or have pre-diabetes or type 2 diabetes.

In my medical practice I see this all the time.  Jim came in for a “wellness check up” and felt happy about his weight.  His BMI (or body mass index) was 22 (normal is 18 to 24.)

He never seemed to gain weight and felt he could “tolerate” a diet that included lots of bread, pasta, and sugar.  He liked his 2 sodas a day and a few glasses of wine at night.  He walked but didn’t do much vigorous exercise or weight training.

When we looked under the hood we found he had a blood sugar of 117 mg/dl (pre-diabetes) and triglycerides of 350 mg/dl, and an HDL of 35 mg/dl.   His blood pressure was 148/96 mmHg (normal is less than 110/75 mmHg.)

And when we measured his insulin levels after taking a sugar drink, they were sky high.    Insulin is the real culprit here – it is the fat storage hormone.  It stores belly fat and leads to hormonal and metabolic changes that cause muscle loss and inflammation, furthering the vicious cycle of pre-diabetes or type 2 diabetes – whether you are skinny or fat.

He was shocked to find out he had severe pre-diabetes and was a ticking time bomb for a heart attack, stroke, and even cancer and dementia.  I treated Jim exactly the same way as my patients with type 2 diabetes.

Get the Right Tests

So how do you know if you are a skinny fat person?

There are a few criteria you can use that can help you identify yourself as having diabesity or being “skinny fat” including family history of type 2 diabetes or early onset of heart disease (heart attack in relative under 50 years old,) or even looking down and see a little pot belly.  And if you are of Asian or Indian descent, you can get diabesity at a much lower body weight.

There are some important blood tests that you should have your doctor do:

  • Fasting blood sugar or glucose (normal less than 90 mg/dl)
  • Triglycerides (normal less than 100 mg/dl)
  • HDL (good cholesterol (normal greater than 60 mg/dl)
  • Blood pressure (normal less than 120/80, ideal less than 115/75)

But there are a few special tests your doctor may not do that you should insist on that tell the true story and help to detect diabesity much earlier. They are:

  • An insulin response test (what most doctors call a glucose tolerance test but with the addition of insulin measurements) that will:
    • Measure glucose (blood sugar) AND insulin levels while fasting and 1 and 2 hours after a 75 gram glucose drink (the equivalent of two sodas.)
    • Glucose should be less than 90 mg/dl fasting and never go above 120 mg/dl at 1 and 2 hours.  Over 140 mg/dl is prediabetes and over 200 mg/dl is type 2 diabetes.
    • Insulin should be less than 10 fasting and never go above 25 or 30 after the sugar drink.  Many with diabesity and skinny fat people can have levels over 50, 100, or even 200.
  • NMR Lipid Particle Test (by LipoScience performed by LabCorp)
    • This measures the size and number of cholesterol particles. You should have less than 1000 total LDL particles and less than 500 small LDL particles.
    • Most cholesterol tests just measure the total amount like 200 mg/dl but the particle test is MUCH better at predicting risk for heart disease.
    • When you are a skinny fat person with diabesity you have too many particles and they are the small dense dangerous kind.

The Cure for the Skinny Fat Syndrome

The cure for the skinny fat syndrome is the same as the cure for someone who is overweight with diabesity.  It is the subject of my latest book, The Blood Sugar Solution.

It is quite simple actually.

  1. Eat a Low-Glycemic Load Diet – lean animal protein (chicken, fish,and eggs), nuts, seeds, beans, vegetables, fruit, and small amounts of non-gluten grains.
  2. Power Up with Protein – start the day with protein and at each meal. This makes your metabolism run hotter and cuts hunger. Incorporate eggs, protein shakes, nuts, seeds, chicken, or fish.
  3. Don’t Drink Your Calories  – no sodas, juices, sweetened drinks and no more than 3-4 glasses of wine or alcohol a week with meals.
  4. Avoid the Deadly White Powder or Flour – including gluten-free flour products. Even whole grain flour acts like sugar in your body.
  5. Beware of Frankenfood – factory-made foods are often science projects with fake ingredients including MSG (which causes ravenous hunger and is hidden as “natural flavoring”,) high fructose corn syrup, artificial colors, preservatives, and chemicals.
  6. Eat from the Right Plant – if it was made in a plant stay away, if it was grown on a plant it is probably ok.
  7. Get an Oil Change  – eat omega-3 fat rich foods including sardines and wild salmon and avoid refined and processed vegetable oils except olive oil.
  8. Get Going and Get Strong:  both cardio and strength training are key. Cardio builds fitness and improves metabolism and strength training builds muscle so you won’t be a skinny fat person.
  9. Take Supplements: they grease the wheels of your metabolism and help burn calories, and balance blood sugar.  A good multivitamin, fish oil (EPA/DHA,) and vitamin D do the trick for 95% of people.
  10. Protect Sleep Time: sleep deprivation alters metabolism and increases cravings for carbs and sugar. Sleep is sacred. Make your bedroom a sleeping temple and stay there for 7 to 8 hours a night.

These latest facts are alarming because  those of us who think we get a pass because we are thin need to take a second look at our health.  You can still be skinny and sick and be metabolically obese – which in the end may be even more dangerous.

The good news is that this is a solvable problem.  Getting tested and working through the 10 steps to being a skinny healthy person is a scientifically proven, effective way to change your biology quickly. And the side effects are all good – increased energy, better sleep and even better sex!  For more information on how to reverse diabesity see The Blood Sugar Solution to get a free sneak peak.

Now I’d like to hear from you…

Please leave your thoughts by adding a comment below.

To your good health,

Mark Hyman, MD

References:

Carnethon MR, De Chavez PJ, Biggs ML, Lewis CE, Pankow JS, Bertoni AG, Golden  SH, Liu K, Mukamal KJ, Campbell-Jenkins B, Dyer AR. Association of weight status  with mortality in adults with incident diabetes. JAMA. 2012 Aug 8;308(6):581-90.

Ribeiro JP, Schaan BD. Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: a systematic review and meta-analysis. JAMA. 2011 May 4;305(17):1790-9. Review.

87 Responses to Are You a Skinny Fat Person? 10 Steps to Cure the Skinny Fat Syndrome

  1. Sherri August 18, 2012 at 12:25 pm #

    I just watched you on PBS, wish I had the money to afford your program at this time – I’d love to start at this very minute. I’m one of those people who had gastric bypass surgery @ 515 pounds. I lost 300 lbs, I kept it off for 10 yrs…..but it is slowly creeping back on and I’m on blood pressure medicine again, I have bowel issues and I wish I was dead; that I’d never had this awful surgery. Yes, I lost weight but I am in constant pain (inflammation?). Is your theory/program the answer to my prayers or just another gimmick?

  2. Ehud Guth August 19, 2012 at 5:26 am #

    Hi,
    In No. 7 of your 10 steps you write: “…avoid refined and processed vegetable oils except olive oil.” Shoud we avoid Flaxseed oil too?

    Thanks,

    Ehud

  3. Melissa Ward August 19, 2012 at 6:10 am #

    Dear Mark Hyman, Thank you for posting this blog about a skinny fat person !! Mdaughter.r who is 7 has soI try to get her to eat healthy. She craves.JSWEETOFTEN! SHE ISN’T ALLOW ED. TO THE COLORS ANNNATTO, VANILLIN,YECOLORING. THESE CUASE H THROAT TO SWELL OR BECOME VERY HYPER . SHE CAN NOT DRINK SODAS EAT CERTAIN CANDIES OR ICE CREAMS BUT I DO WORRY THAT SHE EATS TOO MUCHOF THE UN HEALTHY THINGS & NOT ENOUGH OF THE FRUITS & VEGGIES IHAVESAY I DO GET CREATIVE WITH MY. MEALS. WE EAT THINGS LIK SAUERKRAUT, Humus. BEANS, NUTS SHE IS ALLERGIC TO TREE NUTS. MY FAMILY. DOES HAVE A HISTORY OF DIABETES I MYSELF NEARLY DIED FROM DRINK EXCESS AMOUNTS OF MOUNTAIN DEW & PEPSI. I NOW SUFFER FROM ADRENAL FATIGUE. I AM VERY INTERESTED IN READING THE BLOOD SUGAR SOLUTION.I KNOW IT’S ABOUT LIFESTYLE CHANGES NOT ABOUT JUST NOT EATING OR DRINKING JUNK ! THANK. YOU. SINCERELY. YOU DO GREAT. WORK! THE FONT IN MY POST HERE WAS HARD TO WRITE BECAUSE. THE CURSOR WAS ACTING UP!!!

  4. Nancy Ondich August 19, 2012 at 6:40 am #

    I love your book The Blood Sugar Solution and it is definitely changing my whole life, as I am now beginning to eat “real” food. Staying away from fake manufactured food is making all the difference in my life.

  5. Susan August 19, 2012 at 6:46 am #

    Thanks for bringing up the skinny-fat issue. I think it’s a huge problem, but we are so conditioned in our society to think anyone who is thin is healthy. Not true at all!

    The issue with kids is also alarming, but not surprising. My step daughter is tall and thin–she looks beautiful. But she probably eats 200 g of sugar a day. When I talked to her about it last, her response was “it doesn’t matter because I’m skinny.” I told her why it does matter, but that had no impact. She is a sugar/processed foods addicted child and I worry about her. (Alas, she lives with her mother far away from us and there is very little I can do on a daily basis).

    I’m glad there is more discussion about sugar and the impact. Hopefully, slowly, people will start understanding not only the impact on their health, but how sugar is in EVERYTHING when it doesn’t need to be. And then things may start to change.

  6. Claudia August 19, 2012 at 7:33 am #

    I am reading different things about eating products made with the ancient grains, such as spelt.
    Is the organic spelt bread from LePain Quotidien ok, or is it better not to eat bread, no matter what
    grain it is made with?

    Kind Regards
    Claudia

    • Profile photo of Dr. Hyman Nutrition Staff
      Dr. Hyman Nutrition Staff September 28, 2012 at 3:56 pm #

      Hi Claudia,
      Dr Hyman would suggest you stick to the whole grain itself and avoid processed forms of grains when possible. He also encourages you to take a holiday from gluten and see how your body responds being off of this allergen. Barley, rye, wheat, spelt, triticale etc… Have you seen this article?http://drhyman.com/blog/conditions/gluten-what-you-dont-know-might-kill-you/

      For more personalized attention please connect with Dr Hyman’s nutrition coaching team at: http://www.bloodsugarsolution.com/nutrition-coaching/

      • Bill C. August 3, 2014 at 12:37 am #

        Gluten is NOT an allergen. That’s not to say someone with Celiac Disease isn’t sensitive to it, but there’s no such thing as a gluten allergy. Some people have wheat allergies, but it isn’t caused by gluten. So it wouldn’t necessarily prevent them from eating other gluten-containing grains.

  7. Elle August 19, 2012 at 8:29 am #

    I like your article but don’t agree with “lean” meat (& few other things) as we need the saturated fat. Would love it if you would look @ Weston A. Price foundation and comment in subsequent articles.

    • Gecko August 7, 2013 at 8:37 am #

      Elle, It depends. If I eat organic/ pasture raised meat, I know that the saturated fats are good for me. If the meat Is conventional/ feedlot/ or I’m not sure, I’l avoid the fat since the fat profile is completely different & also holds the most toxins. In a perfect world, we would all have access to affordable organic meat. I shop the organic meat sales & store it in a big freezer.

  8. Dr.Nancy Barin August 19, 2012 at 8:38 am #

    Hi Dr.Hyman,
    Thank you for this very insightful and helpful information on Diabesity and Skinny Fat People. I am dismayed but not surprised that I am likely one of those skinny fat people!! I never realized until now – my weight was within normal limits, and my routine bloodwork is normal, and my blood pressure is normal to low, yet I am always tired, get frequent migraines, and gaining belly fat.
    As a Veterinarian for the past 22 years, I work easily 60 hours a week, and am exhausted after a 12 or 15 hour day. I know my sleep is deprived, I crave bread, pasta, potato chips, (but I don’t usually eat them) and if I eat at all during the day it is not always a healthy meal. I’m on my feet all day wrestling Rottweilers and Labrador Retrievers, so it is not a sedentary job, but I don’t exercise any more – too tired!! I have eliminated or nearly so as much processed foods as I can for the last 10 years, do not drink sodas, never use salad dressings, never use salt, use lots of nuts, fruits and vegetables, add flax seed freshly ground to many of my foods and salads, trim fat off my lean chicken and red meat, use Olive Oil in cooking, eliminated MSG and as much as possible High Fructose Corn Syrup. I take Omega-3 capsules (Res-Q), Osteo-Biflex with 2000 iu D3 , Centrum Silver multi-vitamin. I do not drink, even wine. I do eat alot of pasta, with fresh tomatoes and olive oil, never store-bought sauce. I prefer brown rice, sweet potatoes for starches once or twice a week.
    Yet, from your 10 step list for Fat Skinny People, I need to sleep more and exercise more, and continue to tweek my diet. I also believe menopause had an enormous effect on my body, but I have declined to use the traditional HRT, and I am trying to power my way through it without help. (I am 58 years 7 months, 5’5″, and have ballooned up to140 lbs. My comfortable weight was about 125 lbs.)
    Where is your office located? Alternatively, can you refer me to an affiliated medical office where I can have the appropriate bloodwork requested?
    Thank you for your time and efforts,
    Dr.Nancy Barin

    • Profile photo of HymanStaff
      HymanStaff September 18, 2012 at 1:03 pm #

      If you would like information on becoming a patient at The UltraWellness Center please see “How to Become a Patient” at http://www.ultrawellnesscenter.com. You may also feel free to call The UltraWellness Center at (413) 637 9991.

      Wishing You the Best of Health!

      Dr. Hyman Staff

    • Gecko August 7, 2013 at 8:53 am #

      Dr. Nancy, I would ditch the Centrum Vitamins- They/re synthetic, not food-based, so your body won’t assimilate much from them. Since food-based vitamins/ minerals come from actual food, your body will recognize them & they also provide beneficial components of those foods that we haven’t even discovered yet. I use “Alive Whole Food Energizer multivitamin” (With minerals, 26 fruits & vegs, enzymes…) by Nature’s Way, & it really makes a difference. You can find it @ any health food store. (Unfortunately, they recently formulated a synthetic version I saw for less $ @ Walmart, so be sure to get the Whole Foods version). There are other quality brands of food-based vitamin/ minerals @ health food stores too.

      • Bill C. August 3, 2014 at 12:59 am #

        If you’re going to take vitamins, it doesn’t matter whether they’re synthetic or “natural”. The body will assimilate them both the same way. Whichever kind is used, they should be taken with food to get the most benefit. Obviously, the ideal situation would be to eat enough high-quality food so you don’t need vitamin supplements. I think the amount people need daily is way overblown anyway. And nobody needs fish oil or omega-3 pills. It does nothing but make people rich off others’ gullibility.

  9. Onoosh Gahagan August 19, 2012 at 9:16 am #

    I’m a 66-year-old female, diagnosed as Type 2 in March of 2012. At the time, my only risk factor was my age: healthy weight, water aerobics three times a week, very healthy vegetarian diet,no family history of diabetes. I had broken my foot in November, and so had become involuntarily inactive. I had become very sick: vision problems, polyuria, poludypsia, carpal tunnel in one wrist, anxiety attacks in the middle of the night, nightmares: I thought i was, variosly, feeling the effects of aging, suffering from multiple ailments, or just going crazy. I had just switched to a new medical practice, where, at my first physical, my new doctor took blood, had their lab run tests, and came back to say: “You shoudn’t be diabetic. But you’re diabetic.”

    After a month of insulin, I was using just Metformin, Januvia, and counting carbs. By three months, my A1c was down from 16.5 to 6, and my FBG from 440 to between 80 and 100 consistently. I was probably one of the few people on record to be glad to be diagnosed with diabetes: it explained everything (and had probably gone undiagnosed for a couple of years) and treated everything. I felt like I had been given back my life.

    Still–and here we begin to come to the point–I continued to lose weight. At six months, I was twenty pounds under my Weight Watchers lifetime goal, and looking like the Indian sculpture of the Buddha after his stay among the ascetics. I had never felt so many bones in my body, ever. My BG was also doing odds things: fluctuating during the day, 2hrs. PP, in ways that seemed unconnected to what I ate: a lower-carb meal might spike me at 176; a higher, perhaps only 120 or less. I began reading, and persuaded my doctor to run the tests for LADA. They were definitive: I’m a “1.5,” a creeping Type 1. We discontinued the Januvua, but are observing for ten days before deciding on further changes to my pan. I am still on Metformin. I allow myself no more than 120 carbs a day–my doctor only asked for 150 when this all started–and the blood sugars seem to be creeping up: 90s to 106, with few of those lovely 80s any more.

    Having looked over your list of suggestions, I’m doing everything except the weight training, which I intend to explore. I continue to lose weight, despite eating healthy food–I have overcome my vegetarian principles so far as to eat salmon and sardines, but draw the line at meat–and sleeping well. I sometimes become exhausted in the afternoon (but not every day) and would really like to prevent the complications that can develop with diabetes from happening.

    WHAT can I do? LADA is so little-known (and probably under-diagnosed) that there is much less advice and guidance out there. I have your book and Dr. Bernstein’s, which touch the subject glancingly. What are your dietary and lifestyle recommendations (other than the ones I’m already following) for us 1.5s?

    Thanks,
    Onoosh in SC

  10. Vickie August 19, 2012 at 10:06 am #

    Finally!!! Someone who gets what I’m dealing with! I’m so sick and tired of people saying “You don’t need to lose weight” when I know I do! (Including my doctor) Just finished the 3 week food cleanse from Ultrametabolism and feel great! (Can’t believe I made it through, it was intimidating until I just decided to go for it!) I made my husband and mom do it with me and they are so happy they did! Keep up the good work, Doc!!!

    • Profile photo of Shayna
      Shayna September 4, 2012 at 2:09 am #

      I know exactley what you mean. I wear a size petite 8 but because i have a small frame I do not look obese. I heard the same thing about weight, I don’t really care what the scale says – I just want to be healthy. My body fat is much higher than I want. Mty last blood test showed a glucose of 87 – normal but up from what it was last year and to close to 90 for my liking. Of course, my cholesterol and triglicerides were high. This diet is sort of peremptive strike on diabetes. I also have the Ultrametabolism book and I will look at the 3 week food cleanse. I actually felt sick the first few days without out sugar and white flour. My body is so tricky, I felt i had bad breath and started to suck on a breath mint…and I realized a few minutes I felt better but it was the sugar in the mint. No more Altoids and i will be buying Tic-Tacs!

  11. Candyce Hollingsworth August 19, 2012 at 10:13 am #

    I would like vegan alternative suggestions, so your work would better complement guidelines of others such as Neal Barnard and Joel Fuhrman.

  12. Jenn August 19, 2012 at 10:16 am #

    I have ALWAYS said that more recently (in the obesity epidemic) even the skinny people seem fat, sometimes people who don’t have a high BMI accumulate fat like a flabby tummy etc. People will say, “you don’t need to watch your weight” merely because they don’t look “obese”. Growing up the Chinese (I live in Canada) kids were always super tiny and skinny, now they are still smaller in stature but I see fat Chinese all over!

    • Faye August 20, 2012 at 10:55 pm #

      Jenn,

      I agree with you!
      I live in China and have a great concern for a major part of the younger population in China as they are the typical “skinny fat person” that Dr. Hyman has mentioned in many of his articles.
      The good economy allows them to buy food that was otherwise was not afforded to be purchased, as well as the influence of Western fast food, etc. I believe this is a worldwide problem and it must be addressed.

  13. jen hagen August 19, 2012 at 10:17 am #

    Dr. Hyman,

    I have loved your last two articles. The first being about your own personal journey with health and the second being this one about the skinny fat person. As a person who hopes to be a functional physician, and one who is especially intrigued with neuroendocrinology, I often feel as though many test go undeveloped, due to the focus on pharmaceutical development. As a future practitioner and a mom of two teens with autism, I read about the intricate endocrine system and think, ‘UHM…we really know nothing and these tests are definitely not able to give appropriate numbers on the important stuff.’ YAY for the tests and the solutions you continue to educate us on. I look forward to learning more.

    Best to you and THANK YOU.

    jen

  14. Rachele August 19, 2012 at 10:38 am #

    Dr. Hyman,

    I have a friend who eats eggs everyday, and says that she doesn’t think it effects her Cholesterol levels. I am aware that we need cholesterol in order to function, but there are some levels that can be harmful. Too much of something is not good, and so I try and moderate my diet. I know there is about 230 mg of cholesterol in just one egg, and so I limit myself to 2 or 3 a week max. Also, I suffer from Crohn’s disease, and I only 27, so I have a very modified diet. I can not eat a lot of things because they do not digest well…even lettuce. Is there something you suggest that I eat more of because I am lacking many of the nutrients found in lettuce, and other raw vegetables. I do like fish, and I can eat rice, and potatoes usually just fine, but anything spicy, or raw I have flare-ups. Also, from reading above I noticed for the NMR lipid test you mentioned 1, 000 total LDL particles, and 500 small LDL particles( did you mean HDL here) I was not sure if you made a typo, or that was, in fact, correct. If you could please clarify, that would be helpful, thank you!

    Sincerely,

    Rachele

    • Profile photo of Dr. Hyman Nutrition Staff
      Dr. Hyman Nutrition Staff September 28, 2012 at 4:31 pm #

      Hi Rachele,

      Thank you fro your interest in dr Hyman’s work. For starters please see this article: http://drhyman.com/blog/conditions/5-simple-steps-to-cure-ibs-without-drugs/

      Next, to gain insight into specific dietary tools, tricks and tips for your condition please connect with the nutrition coaching team at: http://www.bloodsugarsolution.com/nutrition-coaching/

    • Danny T July 31, 2014 at 7:57 pm #

      Hi there.
      I’m here to share my opinion based off of my life experience.

      I’ve had high cholesterol in my teens and in fact most of my family does. All of them have one thing in common. They eat vegetarian, almost no cholesterol diets.
      I being the black sheep, do the exact opposite. Once I got on my own, I left for a year straight and went straight up Cyclic Ketogenic diet , which is basically Atkins with carb /junk food up on Saturdays. I ate about 10-12 eggs a week.
      My cholesterol went from 200 (46 HDL good) to 171 (71 HDL!) once I took the blood test again at the end of the year!
      I also dropped 53 lbs from 200 to 147. I seriously ate nothing but animal products.

      I’m the only one in my family completely escaping any sign of heart disease!
      My mom never let my Dad eat any of that, and he still had a heart attack at 52 with high cholesterol. He never so much touched an egg yolk in the last 10 years of his life.

      But why does the body make cholesterol? Inflammation, its trying to fight some other cause.
      http://www.cbn.com/cbnnews/healthscience/2013/february/forget-cholesterol-inflammations-the-real-enemy/

      Hey, I don’t know. Maybe we’re built totally different. I can’t say it will work for you, but dietary cholesterol is certainly not my enemy but totally changed my blood test and my physique. JUST MY OPINION!

  15. Linda August 19, 2012 at 11:47 am #

    I am 62 and weigh 134, down from 199 in 2003. It has been a chip by chip road, and I have been following the basic steps you present. I will have to add resistance training to my treadmill routine. I saw from your link that cardio without resistance training is not good enough. I am eager to beat my remaining high blood pressure, if I can. (My doctor says that if it is too high in the afternoon that is okay, and that it is the average that is important. I say that where there is smoke there is fire. I have to beat the inflammation.) I want to look forward to maintaining excellent health for a long, long time. Thanks for spreading the word about the keys to health. I firmly believe that today’s article fully and simply summarizes the true path, as well as my own missing key.

  16. Rita Maloney August 19, 2012 at 12:02 pm #

    I am working with one of your ntritionists who gave me a number of supplements to be on. I went to my medical doctor who told me that there was a study on multi-vitamins which indicated that multi-vitamins proved harmful and even caused death especially to older women. I was socked by this and confused. When I came home I checked online and found the study in JAMA. Please comment.

  17. Julie August 19, 2012 at 12:51 pm #

    Hi Dr. Hyman,

    I met you recently when you spoke at the ‘Food as Medicine’ seminar in Bethesda, MD. I complained that I was always a petite person but had developed quite a belly and had some other symptoms. I have been eating clean (no dairy/gluten/sugar/refined carbs) since 2001 so i couldn’t understand it. Turns out, I was skinny fat!!!

    After going to a new endocrinologist/ gyno that specializes in bio-identical hormones, he put me on progesterone to counter the estrogen dominance while i am perimenopausal, but most importantly, the HCG nasal spray diet program. I had 29.6% body fat and my Dad had died suddenly of a heart attack at 57, even though he was skinny, in shape, played tennis everyday, etc….

    I was indeed that ‘ticking time bomb’ you referred to in your article and would hate to have a heart attack and leave my 2 small children.

    HCG balances hormones, resets the hypothalmus and metabolism, and reshapes the body w/out surgery. Plus, it only takes the abnormal fat and preserves the structural, necessary fat on the body. I feel like i have hit the jackpot and found the best kept secret in town!!! I am 3 weeks into it and have lost 9 lbs on the scale and inches, but gained muscle and i am fitting in clothes i haven’t fit in in years. (Men and obese folks lose much quicker than me).

    I didn’t think i had much to lose but the doc explained that even skinny people can benefit by the proper redistribution of fat and that the hormone won’t take too much – when you are done, you are done so no danger of overdoing it.
    Btw – this is not the scammy homeopathic placebo stuff – this is prescribed by a doc and requires a compounding pharmacy to fill the prescription.

    They monitor me weekly, give me a b12 shot each week, and it’s been great! Also, doc says that sometimes, diabetics can come off their insulin after 3 days on this program.

    I live by Ultrametabolism and your other books but thought I would offer up yet another way to help those who follow you but are still having issues.

    Thanks,
    Julie

  18. Monica August 19, 2012 at 1:27 pm #

    So my husband has always been over weight since I’ve known him and I’ve always been thin my entire life. As a kid I was alway physically active and extremely fit but as an adult I never have been yet I’ve stayed thin and always had a strong appetite and high motabalisum. My poor husband has tried everything he has ever hard of to try to loose weight but I guess I have never been any help because I figured I’m thin I don’t need to diet. Now that I have 2 kids and it seems like half the time I call my mom there is another story about friends their age dying! It scares me to death! I am not ready to loose my parents and I want to live a long life to watch my kids have kids and more. So I am now turning a new leaf and will do everything I can to be health and help my family be healthy!

  19. Lyndy August 19, 2012 at 1:36 pm #

    Hello Dr Hyman

    I am a vegan and I believe a health conscious person. I am a woman of 45 and overweight. I have especially noticed that my belly is getting fatter. Eating animal products is out of the question because of the suffering they endure. My question is can your book still help me? I don’t want to waste money being told that I must eat fish etc. I simply can’t. I do have your books Ultra Metabolism and The Ultra Simple Diet. To be honest, I pretty much follow the Ultra Simple Diet – I eat oats or smoothie for breakfast. I try to restrict my rice to half a cup twice a day and only eat bread sometimes. I eat vegetables, quinoa, beans, lentils. I walk briskly for 1/2 an hour 4 times a week and do yoga a couple times a week. I eat nuts, seeds, including chia and hemp. I do not think I eat excessively but find it very difficult to count calories. Never drink sodas etc. Use Olive and Coconut oil only. I gave up sugary snacks and lost about one or two pounds but then stopped losing. I must be doing something wrong but not sure. It is possible my protein is less than some.

  20. Fran August 19, 2012 at 2:51 pm #

    I really appreciate the reminders by email and read them thoroughly. I’m still working through the book, “Blood Sugar Solutions,” but started practicing most of the principles more than a month ago, with the encouragement of my boss at work. I feel wonderful, my skin looks younger, the “flab” even seems to be dissipating from my arms and legs, even though I’ve only “lost” 13 pounds. All these years, I’ve considered myself on the small side–when you hang around really heavy people, you feel smaller–but now I understand more about the correct input into my body. It is producing the body I want, the kind that resists disease. I don’t really care how much weight I lose…not because I don’t need to lose, but because weight loss is just a side benefit to being healthy. I’m thinking that if I had been underweight and had begun using these principles, I would have gained the right amount of weight and been healthy. An added benefit to this lifestyle: I don’t have to constantly try to figure out what is too much when it comes to sweets, breads, sodas, etc. It’s totally out, and I don’t miss it!

  21. john rogers August 19, 2012 at 3:54 pm #

    i am losing muscle mass even though my diet is really excellent and i do cardio- i swim for 30 minutes in the open ocean in hawaii about 4 x a week, sometimes less when things get really busy in the evening and then i can t do my swim. my work is often quite physical when i am building homes- framing, siding, roof etc. so this article is a bit of a wake up call for me- i need to do weight training to increase the muscle mass i am losing even though my work is full of lifting. i take natural testosterone gel, levels are about 600- dont want to go too high at age 54, i have been losing weight rapidly lately, not eating enough calories most likely as i eat a ton of vegetables, beans, legumes etc, not too much carbs but certainly enough and mostly healthy carbs, occasional tart frozen yogurt which does have maybe 30 grams of sugar in the size i buy, but generally my diet is stellar, blood tests come back with good cholesterol ratios and low triglcerides, homocysteine and hormones are fine- not sure what is causing this loss of muscle mass. body and belly fat are not excessive but i eat a diet that should cause my body to burn this medium amt of belly fat- it does at times but only when my cardio is on schedule. that really shows me that exercise is king, cant compromise my workout schedule and need to weight train. probably need to see the dr and get a recent workup and do the blood sugar tests with the glucose drink to see if i have insulin resistance etc. very frustrating when i work so hard at being healthy! stress is a killer as well, need to work on reducing that for sure. life is a complex process isnt it?!

    • Paula Wetzel August 19, 2012 at 5:12 pm #

      Dear Dr. Hyman,

      I have been a skinny fat pre-diabetic for over15 years. I exercise regularly and try to eat by your guidelines. (Work goodies are my nemesis!)

      I recently have converted to a vegan diet and find it difficult to get guidance on a low carb vegan diet. I worry that my plant base diet is too high in carbs.

      Would you please provide information for us plant based vegan pre-diabetics?

      Many thanks,

      Paula

    • George Mitchell August 19, 2012 at 8:42 pm #

      John, my first question would be -> How much QUALITY protein are you getting? One thing that I discovered as an older guy (I am 65), is that I need far more protein to maintain muscle mass than when I was younger. Thus I have found it helpful to use concentrated NATURAL whole protein powders along with plenty of protein containing food (much more than just beans and legumes although they are certainly good choices). But weight loss is always good reason to get a checkup. I highly recommend that you see a doctor specializing in functional medicine. For me, adding a skilled functional medicine specialist to my medical team was one of the best moves I ever made. There is no doubt that you can learn a whole lot online, but there is nothing that can take the place of a face to face doctor-patient relationship. And functional medicine docs typically treat their patients as patients, not just as a collection of symptoms. They spend quality time with their patients learning all about them and asking a lot of questions and the results of such an encounter can be life changing. I wish you the best!

  22. Bella August 19, 2012 at 4:26 pm #

    In the above post, you write for blood pressure:

    “(normal is less than 110/75 mmHg.)”

    Further down the post, when writing about which tests to get, you write:

    “Blood pressure (normal less than 120/80, ideal less than 115/75)

    Could you please clarify which of the 3 stated blood pressure levels is correct?

    Thank you.

    • Profile photo of Dr. Hyman Nutrition Staff
      Dr. Hyman Nutrition Staff September 28, 2012 at 4:26 pm #

      Hi Bella,

      Thank you for your interest in Dr Hyman’s work. Aim for your BP to be less than 120/80. Dr Hyman gave the other 2 as examples of what is ideal.

  23. Connie Casebolt, MD August 19, 2012 at 4:48 pm #

    Dear John,

    You are losing muscle mass because your testotosterone level at 600 is still too low. Many physicians and lay people alike are under the mistaken impression that it’s not good to have high testosterone levels. But actually (within reason), the higher the better. In my patients I shoot for levels between 800 and 1200.

    As men age, they produce more SHBG–Sex Hormone Binding Globulin– which leaves less “free” testosterone to be used. So sometimes the total has to be pushed up to get the free into a therapeutic range. Also you should get your estrogen level checked. If that’s too high (over 30), then too much of your T is converting to E and E raises SHBG. Exercising normally restrains this pathway but it should always be checked whenever checking for T levels.

  24. GARRY August 19, 2012 at 7:16 pm #

    WOW ,,,,REALLY THATS A KICK IN THE PANTS,,,,,,,,,NOW SKINNY IS FAT,,,,,,,,IM OVER IT,,,,,,

  25. Sassygal August 19, 2012 at 8:19 pm #

    What is a “warning sign” waist measurement if you weigh 130? My hips are small, but my waist is the same size as my hips. Since I was a teenager everyone was always shocked that the SMALLEST my waist has ever been was 29″.
    Thanks for reading.

  26. Carol August 19, 2012 at 8:42 pm #

    I am one of those skinny fat people. I weigh 124 at 5’3″, a fairly normal weight. I am 64 yrs. of age. I have been measured at several different places and have a Body fat composition of 36%. I have a good deal of fat around my waist and stomach as well as upper thighs. I eat exactly as Dr. Hyman suggests and have for some time. I do not eat gluten or dairy, no processed foods, etc. I exercise several times a week. My blood pressure is normal and my cholesterol is high, but my doctor has done a complete panel and is satisfied that the HDL and the size of the particles are fine. However, my A1C is 5.8, a concern that I am insulin resistant. My dad had Type 2 diabetes and died from heart problems. I am frustrated because I don’t know what else to do. I don’t want to begin medication and fortunately have a doctor that is more alternative in approach and doesn’t want to prescribe it if possible. I have a copy of the Blood Sugar Solution and feel that I am doing everything that it suggests. Any suggestions?

    • Baker August 19, 2012 at 10:55 pm #

      go see a Diabetic Diatitian. Ask your doctor for referral. Bring your current bloodwork.

    • Cathy August 22, 2012 at 1:20 am #

      I am in the same situation as Carol, though a few years younger. I have lost 25-30 lb in the past 14 months for almost 15% weight loss. My HDL is improved, but not > 50, my triglycerides are about 50, real low due to my low glycemic diet no doubt, I haven’t had the particle level checked, but no doubt not the greatest. I exercise aerobically pretty intense 2-3 times a week, do some strength training, and am frustrated at my A1C at 5.7. I take the recommended supplements, my Vit D level is about 60, taking 4,000 IU’s daily plus some in my muti vitamin/mineral supplement. My mother had diabetes on glipizide and avandia I believe, but ate her sweets and carbs. She had difficult to control high blood pressure. Mine is mostly OK, I attribute to exercise. She lived to age 84, but not very good quality of life the last 3-4 years as she made every excuse to not exercise. So the power of genes is obviously something you can’t overcome totally. Oh well, I feel so much better eating this way with more overall energy level. So I guess quality of life is more important than longevity. Attitude is important too, not mentioned along with watching stress levels.

  27. James August 19, 2012 at 10:15 pm #

    Why do you recommend eating only lean meats? Read the research on saturated fats. They are vital for life. Everyone should check their own blood glucose level to see if they are insulin resistance. You can get one from walmart and test strips for under $40. See what foods actually spike your levels.

  28. BB August 20, 2012 at 11:24 am #

    In my opinion, I feel as if this is just another exaggerated state of the conditions that us citizens face on the Standard American Diet (SAD diet). Clearly the issue is health and what we’re putting into our bodies. Regardless of our metabolism and physical state, eating the typical western diet is going to have negative correlations with our health. This just seems like “another issue” to be worried about, when it’s all the same stuff.

  29. Mary Alice Dominguez August 21, 2012 at 6:50 pm #

    I was wondering about the”skinny-fat” or “fat-skinny” person. It seems I have a lot of fat around my belly and it is about to disapppear, then it gets more determined to stay. Recently in nice warm-hot pool water, I was able to move my legs as in taking large steps across the pool without touching the bottom for 1 hour for 3 days. I lost a pound a day and the 3rd day, I lost 3 pounds alone. It was very relaxing and I was surprised I was not tired from the exercise. It could have been the fat that kept me floating easily.Then I came back to LA – a whole new ball ballgame!

    I was surprised to read about the whole grain flour and even the gluten free flour acts like sugar. It does make it easier to stay away from. Here I was concentrating on the if it has milk, to take the lactose capsule, forgot the gluten free for me. I am ususally with-in the normal results for B/P, Cholesterol, HDL, LDL. My age is changing to 70 in September and the reactions to food are also changing. I am considered obese and usually get up to 1/2 hour of exercise when I concentrate on it. At this time I am to stay off my feet as much as possible until the footpain goes away.
    Does portions make a difference in the Low-Glycemic Load Diet? I am hungry about every 2 hours. I have protein at all my meals. When obese should one stay away from even the good fats or just have a very small portion? Salmon and sardines I can eat, the omega-3 capsules cause problems for me. Working in the cardio and strength training you are saying is very important. I will have to plan it out.

  30. Dan Phillips August 23, 2012 at 6:29 pm #

    I am one of the skinny fat people at 6 foot 2 inches and 185# but with an elevated A1-C and fasting blood sugar. I buy your message but I absolutely do not enjoy eating: Asparagus, Spinach, Kale, Brussell Sprouts, Cauliflower and tolerate in small amounts broccoli. I am OK with beans, and fish, and lettuce. I love breads and desserts and sodas. Now I can do without the deserts and sodas but the bread that is going to be tough

    So does that I mean I can be healthy but no longer enjoy eating? I am not sure the choice is worth it but I open to suggestions

  31. Rachel August 24, 2012 at 5:17 pm #

    Carol, do you lift heavy weights or do squats/push-ups etc.? Cardiovascular exercise and low intensity resistance training (weights that are too easy) are useless for growing muscle tissue, you’ve got to eat a lot of protein and do resistance training exercises that are hard enough that you can’t do more than 10 repetitions at once. I’ve been doing that for my skinny fat problem and I’m seeing muscle definition after only 2 weeks! :)

  32. theproblem4meis August 27, 2012 at 12:22 am #

    the thing with me is that I like sweet, semi-sweet as well as carbs. I finally admitted to myself that I’m a ‘dessert person’, even though I said oh no for countless years – it was a facade. I’m going to need to explore alternatives such as beet sugar, but not agave because Dr. Mercola says agave is even more harmful than refined white sugar

  33. Galina L. August 27, 2012 at 10:56 am #

    The people who are adopted to a ketogenic diet will probably have wrong numbers when their glucose tolerance is measured. I think I will.

  34. Sylvia September 14, 2012 at 3:58 am #

    Hi, I am exactly what you describe! I am underweight, BMI of 17. However, I suffer from insulin resistance which has translated into pcos in my body. I am generally thin but tend to suffer weight gain around my mid section only. I am attempting to change my lifestyle however exercise will have to wait for about two to three weeks as I just had a laparoscopy to remove the ovarian cysts two weeks ago. The doctor prescribed metformin and an oral contraceptive to deal with the insulin resistance and hormonal imbalance I suffer from but I am hesitant to take it due to side effects. I want to change my lifestyle instead. Are there any specific supplements I should be taking to boost my body into beating insulin resistance? My own doctor seems to be very conventional and opposed to exploring lifestyle factors. Please guide me as I am from South Africa where doctors who practice more holistically are hard to find, from my experience anyway.

    • Profile photo of Dr. Hyman Nutrition Staff
      Dr. Hyman Nutrition Staff September 18, 2012 at 5:45 pm #

      Hi Sylvia,

      Thank you for sharing your story with us. Of course we can help! If you follow Dr Hyman’s The Blood Sugar Solution, paying careful attention to his dietary advice, you will surely help and heal the inflammatory response of the insulin and improve your sensitivity to it. By following this protocol and his suggested supplements you will see major improvements to your hormones, especially testosterone ( which drives symptoms of PCOS).

      Please get started by taking your quizzes here:http://store.bloodsugarsolution.com/

      Good Luck!
      And for personalized attention and coaching, please visit: http://www.bloodsugarsolution.com/nutrition-coaching/

  35. Jana September 28, 2012 at 1:29 am #

    I’ve been and am still struggling with being a skinny fat female with all sorts of strange but alarming symptoms who has the family history of diabetes and early heart attack yet my doctors gave blown me off. I dont want to end up with diabetes like my mom or die at the age of 49 like my grandfather. My slender frame yet large waist despite being somewhat athletic seemed to not concern my docs. Even when my cholesterol was sky high but had a low almost unheathy bmi and had to have my gallbladder removed at the age of 25 yet not fitting the f’s. I was told i was depressed …i pushed the issue until they finally screempned me and tyears later they found gallstones. I’m lucky because my own education and persistence might save my body when no one else will. I have a love of science, studied biochemistry, and worked in a neuroscience lab studying the brain-gut connection (PBRC) and further trained to think outside of the box while recently finishing an electrical engineering to start figuring out what was wrong and at the same time start trying to do the things right! Unfortunately I’m still trying to figure things out? It’s been 7 years since my surgery and my health has still been plagued with abdominal fat, Issues with metabolism and digestion, inflammation, allergies, pelvic pain, reoccurring ovarian cysts, cognitive impairments…I’ve turned myself into my own research experiment collecting data, keeping a journal of ailments, logging and analyzing my food, meds, fluid etc. The cognitive impairments have been quite bothersome and interfered with my learning and work that I almost had to drop out of engineering school. But I fought my health and battled it and graduated at the top of my class. Im finally making headway with weeding out
    some really bad things. It’s now down to allegry testing and elimination diets. I’m hoping these give me hope and relief. It’s one thing to be feeling bad but until I starting testing my blood sugar on my own dime and taking my blood pressure
    and photographing evidence and passed out on campus in front of faculty-no one believed me and most suggested I needed psychiatric meds. I have two great doctors who have been working with me but the others have made me feel so insignificant and small that I am disgusted and feel a duty to speak up for those who can’t or don’t know better as far as being proactive and preventative. Thank you for your scientific and medical contributions as well as your collaboration with public figures like Dr.Oz to get the knowledge and info out there. I’m very grateful that I’ve had access to health insurance during my health issues because otherwise I’d be in serious financial trouble that would be hard to recover from. I’m happy to have found your website and I will continue to learn about the power I have to posively make changes to my health. I’d be very interested to work with you or collaborate with you . Keep up the good work.

  36. Jana September 28, 2012 at 1:30 am #

    Sorry for the typos-silly tablet technology

  37. kathy October 10, 2012 at 11:23 am #

    Is cold-pressed, non-GMO sunflower oil a good oil to use? It is 9g of monosaturated and 49g poly-unsaturated fat per serving. Total fat is 14 g.

  38. kathy October 15, 2012 at 11:37 am #

    ooops! The sunflower oil I mentioned, is 9g mono, 4 g poly, 1 g saturated fat and total is 14 g.

  39. useful video November 23, 2012 at 9:40 am #

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  40. Ted Rupp December 23, 2012 at 12:26 am #

    Just a question after reading this article. I am a 65 year old male who has been diagnosed as prediabetic. I have followed a close adherence to a paleo diet for more than three years and have always followed a high protein diet. I am a very active person. I have only been regularly weight training for 3 years but my 1 rep maximums are in the elite category for a person of my weight accrding to Kilgore’s tables. Cardio wise i am in the top 20% for my age on the C2 rower. My mile time is near 8minutes. However, I have been diagnosed as prediabetic based on a long term (15 years) fasting blood sugar of 120 to 130. Further information is as follows:
    a1c 5.8%
    Resting Heart rate 43
    BP 128/62
    Weight 155
    Height 5′ 10″
    Caliper body Fat 5 point test 7.5
    Waist to hip = .88
    I probably drink a little more than you recommend but otherwise follow the recommendations set forth above. I work out for 6 to 7 hours a week including resistance training, Cardio work, climbing, skiing and other activities on a less regular basis.
    based on the above, should I be concerned or should I ignore the high glucose readings as being an anomaly arising from genetic metabolic factors?

    • Profile photo of HymanStaff
      HymanStaff January 24, 2013 at 1:00 am #

      Thank you for your message and your interest in Dr. Hyman’s work. Questions regarding conditions like these cannot be answered in a responsible manner via the Internet.

      Wishing You the Best of Health!

      Dr. Hyman Staff

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  42. Kyle February 22, 2013 at 12:02 pm #

    Hi there, Dr Hyman’s article has proved to be very interesting to me. I’m a doc (navy corpsman) stationed with marines and have deployed twice. I’m 22yo 5’7 and only 130lbs. 130 is the most I’ve ever weighed in my life. I go to the gym every day and work on my abs for atleast 2-3 times a week. I’ve started to take protein in the past 4 months but I don’t that’s the issue as my muscles have increased significantly in size including my abs. I I’m pretty sure I fall into the small gut dude category. I have an 8 pack when I flex and when I stand up straight. But I feel as I have a gut. I used to be way more active about 2 years ago before I injured my knee. I was a cross country runner and could run a sub 5 min mile. But lately this whole gut thing has been bothering me. I mean my waist is only 29 inches! Is there anything that I can do to get rid of it? I feel like it may just be my posture and I slouche? Additionally as I mentioned before I haven’t done much cardio cause of my knee, but am one of the fastest runners in my Battalion when it comes time for our semi-annual fitness tests. I’m glad I’m not the only one with this issue!

    • Profile photo of Dr. Hyman Nutrition Staff
      Dr. Hyman Nutrition Staff February 27, 2013 at 3:49 pm #

      Hi kyle,

      Thank you for your interest in Dr Hyman’s work and for your service! There is a lot you can do to increase your vigor from the inside out. For more personalized nutrition advice, Dr Hyman’s nutrition coaching team would be happy to work with you on an individual level to help you reach your goals. To work with the nutrition coaching team please go to: http://www.bloodsugarsolution.com/nutrition-coaching/ OR call (800) 892-1443 to get started.

  43. alsbbbsasda asdam March 3, 2013 at 11:18 pm #

    wow! thanks for that amazing document. I actually loved it on the core. Hope you retain putting up such fantastic content articles

  44. Able-Mae April 7, 2013 at 3:36 pm #

    I AM A LOVELY 53 YEAR OLD BLACK FEMALE I DO NOT LOOK MY AGE AT ALL, BUT MY MID SECTION IS THE GIVE AWAY. I’M 5’51/2 I WEIGHT 170 AND MY STOMACH IS THE BIGGEST THING ON ME.PLEASE DON’T SAY LOSE WEIGHT IF I LOSE WEIGHT I’D BE A TOOTH PICK WITH A BELLY .PLUS I TRYED THAT AND EVERYTHING WENT AWAY EXCEPT THE BELLY:(.RIGHT NOW I’D SAY.I LOOK 5MONTHS PREGNANT I’M ALSO IN MY MENAPAUSE. i’D LIKE TO KNOW WHAT CAN I DO? MY MID SECTION IS THE ONLY PROBLEM OF MY BODY.ALL I WERE IS LEGGINS I REFUSE TO WERE JEANS BECAUSE IF THE FIT IN THE BELLY THEY DON’T FIT ANY WHERE ELSE OR VICE VERSA..HELP!!!

    • Profile photo of HymanStaff
      HymanStaff April 13, 2013 at 12:54 pm #

      Hi Able-Mae,

      Thank you for your message and your interest in Dr. Hyman’s work. We can’t offer advice over the internet but you might consider seeing a practitioner of functional medicine in your area. Chweck out “Find a Functional Medicine Practitioner” link at the Institute of Functional Medicine website: http://www.functionalmedicine.org/practitioner_search.aspx?id=117.

      Wishing You the Best of Health!

      Dr. Hyman Staff

  45. Sierra April 9, 2013 at 11:49 am #

    I definitely consider myself a skinny fat person…
    All my life I have had the constant complaint about my body being fat.
    But I was wrong, it’s not my body that is fat, just my stomach.
    People would get so mad at me for complaining about my weight, given I’m about 95 pounds regularly, and have maintained my weight to be about 90-100 pounds all through high school (I am a college freshman now)

    However, I always had my reasons.
    It’s just my stomach that stores the fat!!!
    My arms, legs, and thighs are all a good size, I have D size boobs right now so it evens out how big my stomach looks, its just my stomach that comes out and I have no idea what to do about it :(
    I definitely gained a freshman 10 (Thank GOD not 15) and am desperate to cut it down but even if I do, my stomach fat will hardly go away.

    What exercises/workout machines/etc do you recommend to target your core and the never-leaving stomach fat?
    Every time I workout I just lose my boobs, and am still left with most of my stomach.

    Drives me crazy!
    But loved this site. Doesn’t make me feel so alone and at least I know theres some hope!

  46. Chuck May 19, 2013 at 5:00 pm #

    Thank you. This is exactly what hit me out of the blue. I was astounded that I was lying in a hospital bed getting insulin while all the fat people were chugging sodas down at McDonalds. I had been living on massive portions of Cream of Wheat and Grape Juice. Healthy foods that nearly killed me.

  47. Good stay at home Jobs for moms May 25, 2013 at 2:26 am #

    diverting write-up. Where did you got all the data from.

    .. :)

    • Profile photo of HymanStaff
      HymanStaff May 30, 2013 at 1:41 pm #

      Thank you for your message and your interest in Dr. Hyman’s work. Please see the references cited at the bottom of the blog.

      Wishing You the Best of Health!

      Dr. Hyman Staff

  48. miranda bullock August 3, 2013 at 12:44 am #

    I’m pretty sure Im a skinny fat person… I’m 15 eat fast food pretty much every other day… And I don’t get something little, I get a lot of it… I don’t exorcise either, I also have like no fat on me Im as skinny as can be… People tell me I should be a model…. I’m like very unhealthy… Anyways I’ve been having chest pains,,,, do you have any idea how I can get rid of them?

  49. Marylynn Belmont August 3, 2013 at 12:27 pm #

    Hi, I am reading your book and I would like to find a doctor in my area, 34203, that will work with me to get my type 2 diabetes under control. I am not fat 5’9″ 170, I exercise and strength train but my sugars are still high (160-200+) first thing in the morning. I DO NOT want to take Metformin anymore, in fact I stopped taking it. I would prefer to control or eliminate the diabetes all together naturally.

    Please help me find a doctor like you here.

    • Profile photo of Dr. Hyman Nutrition Staff
      Dr. Hyman Nutrition Staff August 16, 2013 at 2:19 pm #

      Dear Marylynn,

      Thank you for your interest in Dr. Hyman’s work. To locate a doctor near you who practices functional medicine like Dr. Hyman, go to http://www.functionalmedicine.org/practitioner_search.aspx?id=117 and scroll down to where it says “locate a practitioner” and enter your location. Progress accordingly from there.

      For more personalized nutrition advice, Dr Hyman’s virtual nutrition coaching team would be happy to work with you on an individual level to help you reach your goals. To work with the nutrition coaching team please go to:http://www.bloodsugarsolution.com/nutrition-coaching/ OR call (800) 892-1443 to get started.
      In Good Health,
      The Nutrition Team

  50. Robert August 7, 2013 at 2:07 am #

    Hello Dr. Hyman,

    I suppose I fit in the skinny fat category, however, I am very active, I do boot camp classes, cycle and weight training. Most of my labs are normal but by glucose fasting hoovers in the upper 90s and sometimes low 100s. My LDLs and blood pressure are normal but my HDL seems stuck at 38 for the last couple years. I’m 49, 6’2, 172lbs, African-American. I do have a family history of Type II diabetes.
    I also have a hard time getting to sleep or if I get to sleep okay, I may wake up in less than 7 hours to use the restroom and then cannot get back to sleep.

    I’m thankful for your book and recipe book. I cut juices and sodas out of my diet years ago but I wasn’t aware of the impact whole grain cereals and breads have on blood sugar. I always try to eat a meal that includes protein but certainly wasn’t eating all of the veggies you recommend. I’m also going to cut out diary for six weeks like you recommend and I’ll do my best to follow your Advanced BloodSugar Solution plan. I also read Dr. Furhman’s book, in many ways your recomendations regarding fruits, veggies are the same but he suggests only a little bit of meat or none at all. I also noticed he recommends fruits and oats in his breakfast menu whereas you say to keep fruits to a minimum in the Advanced plan. What are your thoughts on Dr. Furhman’s approach? I get a little confused as to what advice to follow. Given how active I am, I’m concerned that strictly following your Advanced plan will cause me to loose too much weight.

    What I learned from both of you is make veggies the biggest part of each meal and cut out or drastically reduce refined cereals and grains, including whole wheat.

    Please let me know if there is more I should do given my condition. Thanks!

    • Profile photo of Dr. Hyman Nutrition Staff
      Dr. Hyman Nutrition Staff August 16, 2013 at 1:16 pm #

      Dear Robert,

      Thank you for your interest in Dr. Hyman’s work. Dr. Hyman cannot endorse any diet or book in this forum. He would encourage you to keep eating all the vegetables (non-starchy kinds) and definitely include a protein with each meal. If your blood sugars need balancing, then following his Basic plan might be suitable for you. To know for sure, take this quiz and proceed from there:

      https://store.bloodsugarsolution.com/MyAccount/Login?ReturnUrl=%2fQuiz

      For more personalized nutrition advice, Dr Hyman’s nutrition coaching team would be happy to work with you on an individual level to help you reach your goals. To work with the nutrition coaching team please go to: http://www.bloodsugarsolution.com/nutrition-coaching/ OR call (800) 892-1443 to get started.

      In good health,
      The Nutrition Coaching Team

  51. Ashley M September 5, 2013 at 11:03 pm #

    I think I’m skinny-fat. I’m in my early 20s, 5′ 3 and 130 lbs. I’m so unfit and have lost muscle because of high-risk pregnancies and a mid-pregnancy loss. Going up the stairs makes me lose my breath. Going on a walk tonight pushing my kids in a stroller I felt fine. I start talking and sound completely winded. My son asked if I was tired. I keep thinking it’s okay, it’s okay. I’m thin. Pshh. It’s NOT okay. I’m out of shape, I was prediabetic as a teenager…Yeah. Time to change my life. Thanks for the wake up call Doc.

  52. Tara D September 17, 2013 at 11:47 am #

    This is an amazing revelation to me! I was painfully thin until I had a child in my late 20’s. Now at almost 40, I am still a size 4/6, but have an issue with fat through the middle. My friends all make fun of me and say I’m so “skinny”, but I have considered it more of a health issue. I’ll definitely pick up your book and plan to start the 10 steps immediately!

  53. Erena DiGonis October 31, 2013 at 4:35 pm #

    It really does go to show you, don’t judge a book by it’s cover! No matter your outward appearance you have to make sure you are being healthy and treating your body right.

  54. Leonor May 7, 2014 at 11:36 pm #

    Spot on with this write-up, I honestly believe this amazing
    site needs far more attention. I’ll probably be back again to read more, thanks for the info!

  55. Jamie July 24, 2014 at 7:33 am #

    I am trying the protein shake and realize there is a lot of fat from the nuts. Can this be used on someone who has a triglyceride of 180? Will it make it worse.

  56. Thomas Naef September 2, 2014 at 5:55 am #

    First time here and I am quite impressed

  57. Tracy September 29, 2014 at 10:03 pm #

    I am an older woman who has been thin all my life until just about a yr. ago when i started adding a little pot belly. No fat anywhere else. I have been taking the supplements mentioned long before reading this article. I also eat very healthy + always have. I walk a mile or more each day with my dog unless the weather is really foul. I do a whole range of daily exercises yet I still cannot get rid of this little pot belly and it’s really all FAT. I can grab a handful. So here I am following all the rules with no results. Exams show no problems other than this little round fat belly. Bummer!

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