The term “skinny fat” gets thrown around a lot these days, but it sounds a little backwards and confusing…right? And let’s face it: The term itself is loaded, contradictory, and shame-y. But metabolism and weight-management experts admit that it does describe a very real health issue.

People who might be described as “skinny fat” are often at risk of developing the same health issues as if they were medically grouped in the overweight or obese categories—they just don’t necessarily look like it from the outside. (Friendly reminder: You can’t tell what’s going on with someone’s health—physical or mental—just by looking at them.)

Here’s what you need to know about the whole skinny-fat concept.

What does the term “skinny fat” even mean?

“Skinny fat” (or “thin fat,” as some people refer to it) isn’t a medical term. It’s a colloquial phrase usually used to describe people who appear to be thin but are actually carrying more fat than is healthful for their body type.

So, while their body mass index (BMI)—which is based on height and weight only and does not isolate body fat percentage—may be in the healthy range, their percentage of body fat is higher than what has been deemed healthy for their body.

Wait, so do experts generally think skinny fat is a real thing?

Many do. “There are quite a few people that may appear to be lean visibly but, when you actually do an exam on them, carry quite a bit of fat,” says Fatima Cody Stanford, MD, an obesity medicine physician at Massachusetts General Hospital.

“Normal body fat is between 21 percent and 33 percent for women,” adds Vijaya Surampudi, MD, an assistant professor of medicine in the division of human nutrition at UCLA Health. “If someone has a higher percent body fat of 36, 38, or even higher, that is concerning.”

Unfortunately, body fat percentage is taken into account far less than BMI. BMI isn’t a great measure of your overall health—despite the fact that you probably still hear about it at your doctor’s office. Because BMI only factors in your height and weight and doesn’t break down your weight according to what is bone, or fat, or muscle mass, it doesn’t give an accurate picture, says Avigdor Arad, PhD, director of Mount Sinai’s PhysioLab and an endocrinologist at Mount Sinai St. Luke’s.

So, you can be in a healthy BMI group but be metabolically obese, and you can be in the obese group but actually be healthy metabolically. Confusing, yes.

What are the potential health complications associated with having a high body fat percentage, regardless of your body type?

Having a body fat percentage that exceeds what is deemed healthy for your body type “is associated with a high risk of disease,” says Dr. Arad.

But it’s not exactly having any fat that’s the issue. Experts believe that visceral fat (which deposits deep in the body around your organs, and commonly in the midsection) is particularly worrisome because it’s been connected to a slew of health problems, as Harvard Health reports.

The other kind, subcutaneous fat, which sits just below the surface of the skin and you can pinch on your body with your fingers, isn’t thought to have the same health implications as visceral fat. (This might be due to how visceral fat causes an inflammatory response in the body in a way that subcutaneous fat does not.)

To that point: One study published in the Annals of Internal Medicine found that normal-weight people who carried excess weight around their midsections had the highest risk of dying early, even when compared to people who had overweight or obese BMIs.

People who have higher amounts of belly fat and visceral fat in general may be at a higher risk of developing insulin resistance, which can cause high blood sugar to develop, Dr. Stanford explains. Having excess body fat regardless of your body type may also up your risk of developing other serious health issues like type 2 diabetes, cancer, liver disease, heart disease, and a decline in brain health, Dr. Arad adds.

How can I gauge whether my body fat percentage is in a healthy range or not?

There are a few tip-offs that you might be carrying excess body fat that could be impacting your health—even if you are considered a normal weight at the doctor. These are just very general guidelines, though, to help get you thinking about your lifestyle habits that could be contributing to fat gain in particular.

You’ll need a workup from your MD that can measure your body fat percentage to really confirm whether you could be metabolically at risk of the health issues mentioned that may be associated with having a high percentage of fat. And only a doctor you know and trust can really help put your health markers and body fat percentage into context for you. Not every person develops the same health risks or sees the same health improvements when they gain or lose fat—and that’s important to keep in mind. So talk to your doc!

If I’m unsure whether my body fat percentage is in a healthy range or not, what do I do?

If you do want more info about your body fat percentage, your doctor may be able to run a few tests to see what your body fat percentage is, and they’ll help you go from there.

One is called a DEXA scan, which measures the amount of bone, muscle, and body fat in your body, per the National Institutes of Health (NIH). A bioelectrical impedance analysis (BIA) can also help, Dr. Surampudi says; it uses a weak electric current to calculate the resistance in your body (and your fat storage).

Underwater weighing, where the amount of water you displace is calculated to determine your body fat percentage, is also a good method, Dr. Surampudi says.

How can I improve my health if I want to reduce my body fat percentage?

Please know: You’re *not* automatically doomed to develop scary diseases down the road just because of your body fat percentage. But Dr. Arad says it’s a good idea to make some changes now to lower your potential risks for the future. Sure, most of these are pretty common-sense methods to live a little healthier, but it doesn’t hurt to hear them again.

• Eat plenty of fruits and veggies. Plant-based diets are proven to help people not only improve their overall health, but also maintain a healthy weight, Dr. Stanford says.
• Opt for lean proteins. If you eat fatty meats most of the time as your source of protein, consider swapping out steak and burgers for leaner varieties like chicken and fish. If fatty meats are a staple for you, this dietary adjustment may help reduce your body fat, Dr. Stanford says.
• Don’t forget whole grains. Reminder: Carbs aren’t bad or off-limits, but refined carbs like white bread and regular pasta are more likely to contribute to body fat gain than complex carbs like brown rice and corn, Dr. Stanford notes. Fuel up with whole grains more often than simple, refined carbs.
• Move more. If you don’t work out now, it’s a great time to start. That doesn’t necessarily mean you have to go HAM in the gym if that’s not your style, but regular exercise (e.g., 150 minutes of moderate exercise a week), will go a long way toward reducing body fat, Dr. Surampudi says.
• While you’re at it, try resistance training. Lifting weights or doing body-weight exercises is a great way to build up your muscle mass—and that can lower your body fat percentage, Dr. Surampudi says. The more muscle mass you have, the more energy you expend (and fat you burn) even at rest.
• Get plenty of sleep. When you don’t get enough sleep, you’re more likely to snack on crummier foods and may not have enough energy to work out, Dr. Surampudi points out.
• Try to reduce your stress levels. “Stress levels can contribute to excess weight storage,” Dr. Surampudi says. While you can only do so much about your daily stress, try adding routine de-stressing techniques throughout your day, like using a meditation app or trying a few yoga poses when you wake up.

If you’re concerned about your body fat percentage, talk to your doctor. They should be able to do diagnostic work and offer up personalized guidance regarding whether your health might benefit from losing body fat, plus how to actually do that in a safe and sustainable way that makes sense for you.

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