Normal Weight Obesity: a New and Dangerous Condition

When we think of obesity, we often picture individuals with a high weight and a body mass index (BMI). However, there’s a lesser-known condition called normal weight obesity (NWO) that can also pose significant health risks. In this article, we’ll discuss what normal weight obesity is, its causes, health risks, and how to address it.

What is Normal Weight Obesity?

Normal weight obesity (NWO) is a condition where a person has a normal BMI but a high body fat percentage. BMI is a widely used indicator of body weight status and is calculated using a person’s weight and height. A normal BMI ranges between 18.5 and 24.9 for Caucasians, and 18-23 for Asians. However, BMI does not differentiate between muscle mass and fat mass, which means that individuals with a high body fat percentage may still fall within the normal BMI range.

In NWO, excess body fat is often distributed around the abdomen, which is known as visceral fat. This type of fat is more dangerous than subcutaneous fat (which is fat beneath the skin) because it surrounds vital organs and releases inflammatory substances, increasing the risk of various health issues.

Normal Weight Obesity is common in India. A study in rural Kerala found that in those defined as normal weight by their BMI, 32% actually had a high body fat percent. (1)  Therefore, it is important to understand what causes it, the health risks, and ways to get diagnosis and treatment. 

Causes of Normal Weight Obesity

There are several factors that contribute to the development of normal weight obesity (2):

1.  Genetics: Some individuals may be genetically predisposed to store more fat in their abdominal area, resulting in higher body fat percentages despite having normal BMIs.

2.  Sedentary lifestyle: A lack of physical activity can lead to muscle loss and an increase in body fat, even if a person’s weight remains stable.

3.  Diet: Consuming a diet high in processed foods, sugar, and unhealthy fats can contribute to an increase in body fat percentage.

4.  Age: As we age, our metabolism slows down, and we tend to lose muscle mass and gain fat, which can lead to normal weight obesity.

5.  Health Conditions: Some conditions such as polycystic ovary syndrome (PCOS) and thyroid disorders, can affect body composition and result in higher body fat percentages.

 Health Risks Associated with Normal Weight Obesity

Normal weight obesity is not just a cosmetic concern; it is associated with several health risks (2), including:

1.  Increased risk of heart disease: Individuals with normal weight obesity are more likely to develop heart disease due to the presence of visceral fat, which can cause inflammation, insulin resistance, and high blood pressure.

2.  Increased risk of type 2 diabetes: High body fat percentages can lead to insulin resistance, a precursor to type 2 diabetes.

3.  Increased risk of certain cancers: Research has shown that individuals with higher body fat percentages are at an increased risk of developing certain types of cancers, including breast, colon, and endometrial cancers.

4.  Metabolic syndrome: Normal weight obesity is associated with an increased risk of developing metabolic syndrome, a cluster of conditions that increase the risk of heart disease, stroke, and diabetes.

Addressing Normal Weight Obesity

If you suspect you may have normal weight obesity, it’s essential to consult with a healthcare professional for a proper assessment. They may recommend the following strategies to help reduce body fat percentage and improve overall health (2):

1.  Change your diet: Focus on consuming a balanced diet rich in whole, unprocessed foods, such as fruits, vegetables, lean proteins, whole grains, and healthy fats. Limit your intake of added sugars, processed foods, and unhealthy fats.

2.  Increase physical activity: Engage in regular physical activity, including both aerobic exercises (such as walking, swimming, or cycling) and strength training exercises to help build muscle mass and reduce body fat.

3.  Monitor your progress: Regularly track your body fat percentage using methods such as skinfold measurements, bioelectrical impedance analysis, or dual-energy X-ray absorptiometry (DXA) scans to monitor your progress and make any necessary adjustments to your diet and exercise routine.

4.  Manage stress: High levels of stress can contribute to weight gain and increased body fat. Practice stress management techniques such as mindfulness, meditation, or yoga to help keep stress levels in check.

5.  Seek professional guidance: A registered dietitian or nutritionist can provide personalized advice and support to help you achieve your goals.


Normal weight obesity is a hidden health risk that can have serious consequences if left unaddressed. By understanding the causes and health risks associated with this condition, individuals can take proactive steps to improve their body composition and overall health. Remember, it’s not just about the number on the scale; focusing on reducing body fat percentage and building muscle mass is essential for long-term health and well-being.

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