Can a Thin Person Get Type 2 Diabetes?

Anyone can develop Type 2 diabetes — no matter your body size

Is it safe to assume that if you’re slender, you won’t develop diabetes? Not necessarily.

Carrying excess weight is a significant risk factor for Type 2 diabetes, but the disease doesn’t only affect people with a higher body mass index (BMI). Diabetes is influenced by many factors beyond just body weight, including genetics, age and lifestyle choices.

“Diabetes isn’t related to how you look,” says Misty Kosak, a dietitian and diabetes educator at Geisinger Community Medical Center. “Diabetes comes from insulin resistance, which raises blood sugar.”

Insulin is a hormone produced by the pancreas that helps cells absorb glucose for energy. But when insulin resistance occurs, meaning cells don’t respond effectively to it, glucose builds up in the bloodstream and leads to high blood sugar levels.

One reason that thin people get Type 2 diabetes? A condition known as “skinny fat.”

What does skinny fat mean?

Skinny on the outside doesn’t always mean skinny on the inside. Sometimes called “dad bod” or “mom bod,” “skinny fat” refers to someone with a normal BMI and weight, but who carries a higher percentage of body fat compared to muscle mass.

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 might have as much fat as someone who looks heavier.

“The bigger your waist, the more visceral fat you’re likely to have,” says Ms. Kosak. “This hidden fat produces inflammatory substances that can contribute to insulin resistance.”

The medical term for skinny fat is MONW, which stands for “metabolically obese, normal weight.” People who are MONW may look healthy, but are at higher risk for certain conditions as if they were overweight, like Type 2 diabetes.

What are Type 2 diabetes risk factors?

“Even if you’re thin, inadequate physical activity and unhealthy eating can contribute to insulin resistance, a precursor to Type 2 diabetes,” says Ms. Kosak. “Also, things you can’t control like age and family history increase your risk, no matter your body size.”

Besides visceral fat, some other Type 2 diabetes risk factors in thin people are:

Poor diet

You are what you eat. While it may sound silly, there’s truth to this adage — your diet is a big factor in your risk for Type 2 diabetes.

“Diets high in sugar and unhealthy fats can cause blood sugar spikes and lead to insulin resistance,” says Ms. Kosak.

Sedentary lifestyle

Sitting for long periods can change your metabolism and lead to weight gain.

Plus, when you’re inactive, your muscles don’t demand as much glucose from your blood and can cause cells to become less responsive to insulin. Over time, this can lead to insulin resistance, a contributing factor to diabetes.

Prediabetes

Having higher-than-normal blood sugar levels causes prediabetes. Left untreated, it can develop into Type 2 diabetes.

Stress

When we feel stressed, our body releases a chemical called cortisol. Cortisol triggers our fight-or-flight response.

“As part of the fight-or-flight response, cortisol raises your blood sugar level to respond to immediate challenges,” says Ms. Kosak. “Chronic stress over time can lead to weight gain, insulin resistance and Type 2 diabetes.”

Fatty liver disease

Having a condition known as fatty liver disease puts you at risk of developing diabetes. There are 2 types of fatty liver disease. The primary type is caused by excessive alcohol consumption. The other type, non-alcoholic fatty liver disease (NAFLD), is caused by a buildup of fat in the liver.

If you have fatty liver disease or other Type 2 diabetes risk factors, talk to your healthcare provider. They can work with you to develop a plan to lower your risk of developing diabetes.

What are the symptoms of Type 2 diabetes?

If you’re at a normal weight, diabetes symptoms probably aren’t on your radar. But recognizing symptoms for early diagnosis can significantly prevent complications and manage the condition effectively.

Symptoms of Type 2 diabetes include:

Frequent urination, especially at night
Increased thirst
Unexplained weight loss
Constant fatigue and lack of energy, even after a good night’s rest
Slow healing of wounds or infection

“High blood sugar levels in the blood damage nerves, arteries and other tissues,” says Ms. Kosak. “Diabetes going unchecked can lead to serious complications over time, including heart disease, kidney damage, nerve issues and vision problems.”

If you have symptoms, schedule an appointment to discuss diabetes screening options.

Tips to help prevent Type 2 diabetes

You can’t change certain risk factors like family history and age, but with a few minor lifestyle modifications, you can lower your chances of developing Type 2 diabetes.

Not sure where to start? Consider these:

Eat a balanced diet. To feel your best, eat a diet rich in vegetables, fruit, low-fat dairy, whole grains and lean meats or plant-based protein to help regulate blood sugar. Limit refined sugars and carbs, processed foods and saturated fats, which can spike blood sugar.
Get moving. There’s hope for couch potatoes everywhere. Being active helps reduce your risk of diabetes by improving insulin sensitivity — and helps the body use glucose more effectively. Another bonus: You may even shed a few pounds. How much activity do you need? Aim for 150 minutes of physical activity per week. Think brisk walking, swimming or lifting weights.
Reduce your stress levels. No one likes feeling stressed out. Besides making you feel good, managing stress is good for you. For less stress, start small. Focus on getting more exercise and better rest, staying connected to the people you love and getting a few laughs. You also can practice meditation or deep-breathing exercises to manage chronic stress.
Get enough rest. Make sure you’re getting enough quality sleep. Establishing a regular sleep schedule can help give you the restful sleep your body needs — about 7 to 9 hours each night.
Quit smoking. Nicotine increases your blood sugar levels and makes the body’s cells less responsive to insulin. But quitting can reduce your diabetes risk significantly and improve your overall health.

Having trouble making changes? Your healthcare provider can recommend resources to help you live your healthiest life.

“Maintaining healthy habits benefits everyone, regardless of your current weight or diabetes risk,” says Ms. Kosak. “Weight is a risk factor, but it’s only one piece of the puzzle. People of all shapes and sizes — and yes, weights — can develop Type 2 diabetes.”