Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes
“Obesity is genetically common in our family. I was being gaslighted and judged by a bunch of obese people, most of whom were doing nothing to improve their health and obesity issues. Yet they fully believe to this day that I am just naturally thin and could not possibly understand their obesity issues. When all I have ever suffered from is normal weight obesity and, in my adult years, being overweight and obese, no matter how diligent my diet, exercise, and lifestyle.”
Marc Nelson is a scientific researcher.
He shares his story and discusses his KevinMD article, “My journey being gaslighted about obesity, skinny fat, and body type.”
Did you enjoy today’s episode?
Rate and review the show so more audiences can find The Podcast by KevinMD.
Subscribe on your favorite podcast app to get notified when a new episode comes out.
Click here to earn 1.0 AMA PRA Category 1 CME for this episode.
Also available in Category 1 CME bundles.
Powered by CMEfy – a seamless way for busy clinician learners to discover Internet Point-of-Care Learning opportunities that reward AMA PRA Category 1 Credit(s)™. Learn more at about.cmefy.com/cme-info
Do you know someone who might enjoy this episode? Share this episode with anyone who wants to hear health care stories filled with information, insight, and inspiration.
Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.
Transcript
Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Rate and review the show at KevinMD.com/rate. Subscribe at KevinMD.com/follow. Today on the show, we have Marc Nelson. He is a scientific researcher, and his KevinMD article is titled “My journey being gaslighted about obesity, skinny fat, and body type.” Marc, welcome to the show.
Marc Nelson: Thank you for having me.
Kevin Pho: We’ll get into your article in a little bit. First off, share your story and journey to where you are today.
Marc Nelson: Yeah. So when I was eight years old, I was actually a star soccer player on a state championship team, and I began noticing during shirts-off soccer practice that my body was very different from my peers’. When I would go in and see my doctor, they would run me through all the tests, and I would be totally normal relative to my safe BMI weight range, and that’s all that they really cared about. This was in the mid-1980s, when the BMI had just become standard.
So when I would bring up all this skinny fat all over my body, there was no term at the time for skinny fat. There really was no term at all other than normal or not normal relative to your BMI. So when I would bring it up to my parents or the doctors, “What’s up with all this fat all over my body when I’m well within my safe BMI weight range?” no one listened and no one cared, because I was well within my safe BMI weight range.
Well, as the years passed and I hit puberty, and I was a late bloomer, more fat grew and no muscle grew, and I ended up having to quit all competitive sports because I didn’t have any muscle on my body, and you can’t be an athlete if you don’t have muscle. So as I got into college, I was determined to understand what was wrong with my body and why it was covered in so much fat even when I was well within my weight range, and nothing really fixed anything. By the time I left college, I took a job at CU Boulder doing scientific research, and it was from that point on that I was determined to open up my own research center and figure out why I was so different.
Real physician voices, twice a week
Free, and one click to unsubscribe.
Kevin Pho: You talk more about that story in your KevinMD article, “My journey being gaslighted about obesity, skinny fat, and body type.” Now, as you were growing up, you’re saying that there were no resources that you could turn to. Did you ever talk to a pediatrician or physician or any type of health care professional about some of the issues that you talked about?
Marc Nelson: You know, I did, but again, the BMI is so ingrained in terms of being the standard. I was well within my safe BMI, and at the time there was no terminology for skinny fat, which is cellulite, thin fat, loose skin, crepey skin, thin fat, and normal-weight obesity. Most people don’t realize that obesity is defined as having too much fat on your body. It’s not about being overweight, because then folks like Dwayne Johnson would be, quote unquote, obese, when he’s not. He just has a bunch of extra muscle on his body. Obesity is defined as having too much fat on your body.
So I was well within my safe BMI weight range, but I had fat all over my body, and now there’s a term for it. It’s called normal-weight obesity. When I was at CU Boulder, I had really good health insurance, and I went and saw every specialist, and they poked and prodded and did all the tests, and they came back and said I was totally normal. And when I would address it with the doctor, in the actual room I was standing in with him, “What’s up with all this skinny fat all over my body, all this fat on my body, even though I’m well within my safe BMI weight range?” there was no response and no answers, because they didn’t have any answers.
That’s the downside right now of our current body type standards: They are simply inaccurate. They need to be strengthened. So I’m not knocking the fact that we have standards. I’m simply saying that we need to make them more accurate.
Kevin Pho: So when you talk about normal-weight obesity, tell me about the prevalence of that and the scope of this condition.
Marc Nelson: We don’t really know the answer to that right now. That term has really only been around for the last decade or so, and it’s gaining credence in the medical world, but we don’t really know right now, and that’s one of the things that our research here at Fellow One Research is looking at.
So according to mainstream science and medical doctors, when I go in and see my doctor, when anyone goes in and sees their doctor, you are being held to the Body Type One standard. It’s that standard image that you see in any scientifically approved human body anatomy book. And we need a standard. I’m not knocking the fact that we have a standard. It’s just not an accurate standard, because it’s not taking into account skinny fat, all the different forms of skinny fat. The second standard is the body mass index, and again, it’s not accurate, because it’s not taking into account skinny fat. The third standard is the BMR, the basal metabolic rate, which is the number of calories that your body requires daily, and that standard is also not accurate, because it doesn’t take into account skinny fat.
We know according to science that one pound of muscle mass burns six calories daily, but one pound of fat or skinny fat only burns two to three calories daily. So if you’re someone like me who’s dealing with normal-weight obesity, having skinny fat on your body when you are within your normal, safe BMI weight range, you need fewer calories daily, because you have skinny fat on your body, and skinny fat burns fewer calories than muscle.
Kevin Pho: So in terms of normal-weight obesity and skinny fat, tell us about the health implications of that condition going forward.
Marc Nelson: Yeah. So basically right now, again, with the limited scientific data that we have on those terms, the scientific data that we have right now shows that if you are dealing with normal-weight obesity, you are dealing with the same general risks as if you had obesity. We know obesity is a disease, and it carries with it serious risks in the short and long term, including heart issues. There’s a whole plethora of health issues that come with that, along with the skyrocketing health care costs that come with it as well.
Kevin Pho: So how does one diagnose being skinny fat or normal-weight obesity? Is it within the body mass index reference ranges, and then you calculate a percentage of fat or muscle mass? How does one go about diagnosing this?
Marc Nelson: So again, that’s a great question, but I don’t think that we have a standard way of diagnosing that at this point, which is one of the reasons why we are working on the research that we are here at Fellow One Research: to understand what skinny fat really means and how we improve our current body type standards so that we can improve the ability of medical doctors to actually properly diagnose this. So I don’t think that right now we currently have a standard. Again, the only three standards that we currently have are Body Type One, the BMI, and the BMR, and our research is looking to bring forward the scientific data so that we can strengthen those and actually come up with a real way of diagnosing skinny fat in all its forms.
Kevin Pho: So when you bring your data to traditional medical organizations, in general, what’s their response to normal-weight obesity?
Marc Nelson: You know, right now, not very good. There are a few organizations, like the Mayo Clinic, which have their definition of normal-weight obesity up on their site, so it is gaining ground. But we are currently working on funding so that we can take our research to the next level and get a battery of peer-reviewed papers out on it and such. So unfortunately, the current state of mind relative to skinny fat is not as strong as we would like it to be. But that, in general, is the nature of science. There’s always data and evidence and facts rolling in, and as they do, we change the way that we see science and everything relative to it. So that is our goal.
Kevin Pho: We’re talking to Marc Nelson. He’s a scientific researcher, and his KevinMD article is titled “My journey being gaslighted about obesity, skinny fat, and body type.” So, Marc, when you talk about normal-weight obesity to your medical professionals, has their response differed or changed compared to when you were a youth?
Marc Nelson: Unfortunately, no. And again, I think that is simply because doctors are under an immense amount of pressure to know everything and to get everything right, and that’s got to change as well. We need to balance out the amount of responsibility that doctors have relative to our health and our own responsibility relative to our own health. That is learning what our real body type is, and once we understand what our real scientific body type is, what is the best diet, exercise, and lifestyle that is science-based that can help us maintain our actual body type so that we’re as healthy as possible. That’s instead of this current model, where right now we go to the doctor and we expect the doctor to know everything about everything and to heal everything about ourselves if we’re dealing with any unhealth, and that’s just not reasonable for anyone.
So things really haven’t changed. They still don’t listen, and that’s one of the galvanizing principles behind our actual research: We’ve got to change that, so that there is better understanding with both doctors and the actual layperson, so that we are healthier in general and we can wrangle things like the current obesity epidemic, which is global.
Kevin Pho: So tell me the path forward when it comes to normal-weight obesity.
Marc Nelson: We are working on funding, as I mentioned. So the first step is strengthening, as best as we can, our scientific research relative to our online work. But our ultimate goal is to open up a research center, to have MRI machines, to have a medical team and a research team, and to really focus on how we properly judge normal-weight obesity and other forms of skinny fat so that we can properly diagnose it and so forth. So our research center is our main goal, but the path forward is most certainly bringing forward the science and doing it right.
Kevin Pho: And my final question: What are some of your take-home messages that you want to leave with the KevinMD audience?
Marc Nelson: One, thank you for having such an outstanding website and for bringing me on the show. I really appreciate it. You know, when it really boils down to it, please realize that so much of the stuff happening on social media is just wrong. It’s just not accurate. We’ve got all these photoshopped and filtered images, and people are trying to be held to these body type standards that they simply can’t meet, because their genetics won’t allow them to actually meet that.
So I would say recognize that body type is genetics. Once you understand what your scientific body type is, have respect for your genetics, and then once you can get there, you can figure out the best science-based diet, exercise, and lifestyle for your specific body type. You can go to our website at fellowone.com. We have our scientific body type quiz and our scientific weight loss program diaries, and you can learn more about them and hopefully wrangle your own health. But follow science, please. It’s here for a reason, it works well, and it’s really the only way that we get ourselves out of the current mess that we find ourselves in.
Kevin Pho: Well, thank you so much for sharing your time and insight. Thanks again for being on the show.
Marc Nelson: Thank you for having me.
Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes
