Many Indians maintain a slim appearance, with a body mass index (BMI) below 23 and no visible signs of obesity. They eat home-cooked food, stay moderately active, and feel generally healthy. Yet for thousands each year, a routine blood sugar test delivers an unexpected diagnosis: diabetes.

The Hidden “Thin–Fat” Phenotype Explained

This paradox is explained by what experts describe as the “thin–fat” Indian phenotype. While the body may look lean from the outside, excess fat often accumulates internally around the abdomen, liver, and even within muscle tissue. This hidden fat interferes with how the body responds to insulin, leading to insulin resistance and a rapid rise in blood sugar levels.

Evidence from large Indian studies highlights the scale of this problem. Data from the ICMR-INDIAB programme show that nearly four out of ten normal-weight adults already carry metabolic risks such as increased waist circumference, high blood pressure, abnormal cholesterol levels, or elevated fasting glucose. These hidden risks raise the likelihood of developing diabetes several-fold, even in the absence of obesity. Importantly, this pattern is seen not only in cities but also across rural India.

Why Slim Indians Are Biologically More Vulnerable

Another critical factor is reduced insulin-secreting capacity of the pancreas, which is common among Indians. Research shows that many slim Indians produce less insulin to begin with, and this response weakens further with age, stress, and dietary excess. Genetic predisposition compounds the risk, making young-onset diabetes increasingly common even among people in their 20s and 30s.

What makes this condition particularly dangerous is its silent progression. There are often no early warning signs such as fatigue or pain. Risk builds gradually over years, driven by a combination of family history, reduced physical activity, high-salt and high-carbohydrate diets, and disrupted daily routines.

Recent lifestyle trends have intensified this risk. Changes in eating patterns, frequent snacking, increased intake of sugary drinks and refined carbohydrates, and reduced physical activity have collectively added fuel to an already vulnerable metabolic profile.

USV Pvt. Ltd., a leading pharmaceutical company, conducted a nationwide survey to understand the impact of the lockdown on the diet of the Indian population. The survey revealed that one in five respondents ate extra meals daily, nearly 38 percent snacked more between meals, and one in three increased their overall food intake. Additionally, 63 percent cut back on physical activity, and 27 percent gained weight. These habits are adding fuel to the fire.

Easy Steps To Protect Yourself

• Measure your waistline regularly. Aim for less than 90 cm for men and 80 cm for women.


• Check blood sugar once a year, even if you feel perfectly healthy.


• Limit salt intake to about one teaspoon a day and reduce packaged or restaurant foods.


• Stay active with at least 30 minutes of walking or physical movement daily.]


• If diabetes runs in your family, start screening early and encourage others at home to do the same. 

Disclaimer: The information provided in the article is shared by experts and is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.