He runs three times a week. His BMI is perfectly normal. No one has ever called him overweight. And yet, his blood sugar levels say otherwise. This is becoming a familiar story in urban India, people who look fit on the outside but are diagnosed with diabetes.
It’s often called “skinny diabetes”. “This is not rare anymore. We are seeing insulin resistance in people who appear completely healthy by conventional standards,” says Dr Gagandeep Singh, Founder of Redial Clinic.
Why BMI isn’t telling the full story
For years, Body Mass Index has been the go-to measure of health. But it was never designed with Indian body types in mind. “South Asians tend to store fat differently. We can appear slim while carrying fat around internal organs like the liver and pancreas,” explains Dr Singh. This internal fat, often called visceral fat, is far more harmful than what you can see.
And it doesn’t show up on the weighing scale.
What’s actually happening inside the body
The issue isn’t weight. It’s metabolism.
Urban lifestyles have created a pattern:
- High-carb diets (refined flour, rice, sugar)
- Low muscle mass due to sedentary work
- Poor sleep patterns
- Chronic stress
“A thin person following this lifestyle can be metabolically similar to someone who is overweight,” Dr Singh notes. Without enough muscle to absorb glucose, the body struggles to manage even moderate carbohydrate intake.
Over time, insulin levels rise, and eventually, the system begins to fail.
The signs most people miss
Because the body looks “normal,” early warning signs are often ignored.
But they are there:
- Feeling tired after meals
- Slight increase in waist size despite stable weight
- Dark patches on the neck or underarms
- Borderline fasting sugar levels
- Rising triglycerides
“These signals are far more important than body weight alone,” says Dr Singh.
Why this is becoming more common
The shift is subtle but widespread. Long hours at desks, convenience-driven eating, late nights, and high stress levels are quietly changing metabolic health across cities. The body adapts, until it doesn’t.
What actually helps
The solution isn’t about losing weight. It’s about building metabolic strength.
- Strength training to build muscle (this is essential)
- Reducing refined carbohydrates
- Increasing protein and healthy fats
- Improving sleep quality
- Managing stress consistently
“Stop assuming that thin means safe. Metabolic health is invisible until it isn’t,” Dr Singh explains.
Looking fit is no longer a guarantee of being healthy. The real question isn’t what your body looks like. It’s how it’s functioning. And in many cases, the warning signs are already there, just quieter than we expect.
Also read: The ‘healthy-looking’ trap: What your body may be hiding
