20% Of People Considered "Lean" Are Metabolically Unhealthy: Why It's Hard To Tell
When you think of "metabolic dysfunction," chronic conditions like obesity, diabetes, heart disease, and so on may come to mind. But according to family medicine physician Julie Foucher-Urcuyo, M.D., M.S., you don't have to suffer from any of those conditions to have metabolic dysfunction. In fact, she tells me on this episode of the mindbodygreen podcast that 20% of people considered "lean" are still metabolically unhealthy1.
That's because, according to Foucher-Urcuyo, weight is only another symptom of metabolic dysfunction; it's not necessarily leading the charge: "If we only focus on the weight, we miss the forest through the trees," she adds.
So how can you tell if you're metabolically unhealthy, regardless of weight? It's a little more difficult than you think, but it's not completely impossible (and before you panic, know that there's much you can do to get your metabolic health back on track).
Why it's so hard to tell.
Slightly different from metabolic syndrome, "Metabolic dysfunction is any abnormal regulation of blood sugar, lipids, or a chronic state of inflammation that leads to disease later on," Foucher-Urcuyo says. That said, metabolic dysfunction doesn't just appear as chronic disease one day—it builds up over years silently. When those conditions start to become noticeable, oftentimes they've been wreaking havoc internally for quite some time.
"It's hard for people to make changes because [metabolic dysfunction] can stay silent for so long," she says. Specifically, metabolic dysfunction tends to arise in three distinct phases:
- The first phase: "This is when those processes are starting, but it's silent," says Foucher-Urcuyo. "You don't know anything is wrong."
- The second phase: This phase is what Foucher-Urcuyo calls "the chronic disease phase." Perhaps you're diagnosed with high cholesterol, diabetes, or any of the other chronic conditions mentioned above. "You don't feel any different, but you're diagnosed with a 'disease,'" she explains. "This can continue for many years."
- The third phase: And, finally, the last phase of metabolic dysfunction is when those chronic conditions become difficult to ignore—at this point, the dysfunction starts to affect your quality of life. "This phase has a lot more morbidity and mortality," says Foucher-Urcuyo. "Heart attacks, strokes—it's the end stages of this process that we're all trying to avoid."
What to do about it.
"People often realize they need to make changes, but by the third phase, the process could be going for 10, 20 years," Foucher-Urcuyo explains. That's why the key to combating metabolic dysfunction is not to wait until the third and final phase—it's to address the issues while they're silently accumulating in your body. "You have to take a look under the hood," she adds. "Really see what's going on inside."
In other words, check up on your blood pressure, your triglyceride-to-HDL ratio, your fasting blood sugar levels: All of these can shed light on any abnormalities brewing in your body. Just because you don't experience any symptoms (or are not considered "overweight") doesn't mean you have a free pass from metabolic dysfunction. As Foucher-Urcuyo notes, "People who have risk factors only need to check one of those boxes." And considering only 12.2% of Americans meet all the healthy criteria, it makes sense a staggering number of individuals—no matter their weight—face some sort of risk to their metabolic function.
While the statistics can sound scary at times, you do have the ability to check up on your health and make sure you fall into that healthy 12.2% subgroup. And if you do find you meet one of those metabolic risk factors, don't panic: The good news is you've identified a problem before it becomes severe, and there are plenty of lifestyle interventions to try to make sure your metabolic function runs in tiptop shape.