A Body Mass Index (BMI) in the “normal” range can be a dangerously misleading indicator of health, especially for individuals of certain ethnicities like South Asians. Many people in this category are “metabolically challenged” despite not being overweight, a condition that hides a high risk for cholesterol-driven heart disease behind a veneer of healthy weight.
This paradox arises from differences in body composition. A person with a normal BMI can still have a high percentage of body fat and a low percentage of muscle mass. Crucially, they may have a high amount of visceral fat—the dangerous fat that surrounds internal organs and drives metabolic dysfunction.
This internal state of being “over-fat” despite being “normal-weight” often leads to atherogenic dyslipidaemia. This is the unhealthy lipid triad of high triglycerides, low protective HDL, and an abundance of small, dense, artery-clogging LDL particles. This profile significantly increases the risk of premature coronary artery disease.
For this reason, relying on BMI alone is a fallacy. For these individuals, modest weight loss of even 5-10% can produce outsized cardiovascular benefits. This small reduction in weight often targets the harmful visceral fat, leading to dramatic improvements in their entire lipid profile and overall metabolic health.
The key takeaway is to look beyond the scale. If you are in a high-risk ethnic group, it’s crucial to get a full lipid panel and discuss your metabolic health with your doctor, regardless of your BMI. Management should focus on healthy habits like a whole-food diet and regular exercise, which improve body composition and metabolic function, not just on hitting a target weight.