Looking slim doesn’t always mean being healthy, and that’s a reality many people are only now beginning to understand. Medical experts warn that one of the biggest myths around Type 2 Diabetes is that it only affects overweight individuals. This belief, they say, is leading to delayed diagnoses, especially in India.
Doctors often see patients who appear perfectly fit but already have high blood sugar levels. These individuals may have a normal weight and body mass index (BMI), yet still develop diabetes. Experts explain that this delay in diagnosis can cost valuable time when early treatment could have made a big difference.
India, in fact, has a high number of such cases, often referred to as “lean diabetes”. Studies suggest that nearly 20–30% of Indians with Type 2 diabetes are not overweight by standard BMI measures. The real issue, experts say, is not how much fat a person has, but where it is stored.
They point out that BMI is not always a reliable measure for Indians. Originally developed using European populations, BMI only compares weight to height and does not show how fat is distributed in the body. This means a person can have a normal BMI but still carry harmful fat internally.
This hidden fat, known as visceral fat, builds up around organs like the liver and pancreas. It is especially dangerous because it affects how the body handles insulin. Experts explain that this type of fat releases substances that lead to insulin resistance and long-term inflammation, both of which increase the risk of diabetes.
Because of this, doctors suggest looking beyond the weighing scale. One useful measure is the waist-to-height ratio. A ratio above 0.5 is considered a warning sign, even if a person looks slim.
Another challenge is that common tests may not detect the problem early. Standard fasting glucose tests often miss early signs of metabolic issues. By the time results become abnormal, the damage may already be underway. Experts recommend more detailed tests like fasting insulin levels and HOMA-IR scores, which can identify problems earlier. In some cases, continuous glucose monitoring is also used, and it often reveals sharp spikes in blood sugar after meals—even when fasting levels appear normal.
Diet is another important factor. Experts say that a typical Indian diet, especially vegetarian meals high in rice, roti, and dal but low in protein, can increase the risk. The concern is not just how much people eat, but the balance of nutrients. High carbohydrate intake combined with low protein can worsen insulin resistance, particularly in those already at risk.
To manage this, doctors often advise increasing protein intake, cutting down refined carbohydrates, and including healthy fats like ghee or olive oil. These changes can improve metabolic health within weeks, even without major weight loss.
Experts stress that being slim does not guarantee good health. True fitness depends on what’s happening inside the body, not just what is visible on the outside.
