Health and wellness touch everyone’s life differently. This is one person’s story.

For the first 37 years of my life, I had always been that girl.

It was — *humble brag time* — easy for me. No ice-cream, cake (yes, I have a sweet tooth), or lack of a vigorous workout could make me gain more than a pound or two, which always miraculously seemed to simply fall off when I wasn’t trying.

But last year, during a routine cholesterol test — my first, actually — I stumbled upon a dirty little secret that my body was hiding. Turns out, I’m what Google refers to as “skinny fat.” Translation: Inside my thin frame, I have a very unhealthy body.

We could all have health problems at any size, and we might not even know it.

On the outside, I look healthy and fit. I have a size 2 body. But I don’t actually fit the part society says a smaller body should.

Inside this body? I’m unbalanced and have major health issues. My cholesterol was so high, I was approaching stroke levels (per my father, a cardiologist, who interpreted the results for me).

Say wha?!?

But this trend is more common than you may think

A 2008 study found that about a quarter of Americans who aren’t overweight have some form of an unhealthy heart risk, like high cholesterol or high blood pressure.

Yup, turns out, high cholesterol can bury itself in any body: big or little, wide or narrow, over or underweight — or anything in between.

Within the skinny body, there could be veins and veins of fat. We just don’t think of it because our culture has continued to use images of skinny people to mean “healthy.”

Sure, smoking along with eating foods high in cholesterol like red meat or ice-cream severely impact your high cholesterol risk (my diet is super high on the latter), but apparently, since high cholesterol runs in my family, I was very likely to get it, skinny or not.

“High cholesterol does not discriminate against body type, and body weight does not determine if a person suffers from high cholesterol or high triglycerides (a type of fat in the blood),” says Peter Toth, director of preventive cardiology at CGH Medical Center in Sterling, Illinois.

“People who appear to be thinner assume they are not at risk. Therefore [they] don’t heed the appropriate steps to take toward a healthier lifestyle, which may lead to higher cholesterol and triglyceride levels, and, ultimately, heart disease” he says.

Get your cholesterol tested early

  • The American Heart Association recommends that you start getting cholesterol tests every four to six years, starting when you’re 20 (ooops, on my part!).
  • If high cholesterol runs in your family, you should start even earlier and get tested more often.

It’s all so confusing.

Even marathon runners could be storing cholesterol and other heart-stopping issues within their perfectly toned bodies. Remember Jim Fixx, author of “The Complete Book of Running”? He died of a heart attack in 1984.

Well, that attack was due to blocked coronary arteries (he also had a family history of heart disease, had smoked earlier in life, and had a stressful career).

He’s not an anomaly though: a recent study in Missouri Medicine found that excessive exercise — or marathon running — can increase coronary plaque.

So when people talk about “skinny fat” — they mean it, literally! Within the skinny body, there could be veins and veins of fat. We just don’t think of it because our culture has continued to use images of skinny people to mean healthy.

Here’s how it happened: Much of cholesterol is due to genetics

Your body produces cholesterol, and some people simply make more of it.

“So if you have a genetic predisposition to high cholesterol, yours will likely be elevated no matter how much you weigh,” says Susan Besser, family physician with Mercy Personal Physicians in Baltimore. “No amount of dieting will fix it.”

The opposite may also be true — you may be overweight, but if you have the high-cholesterol gene, you’re more likely to have normal cholesterol levels, she says.

And trust me, genetics matter a lot

My doctor immediately wanted to put me on cholesterol-lowering medication, but I requested a chance to lower it myself. I was already taking a few pills daily to prevent migraines, so I didn’t want to be adding more to my nighttime routine.

I’ve been writing about health and wellness for more than a decade, so I knew exactly what I should be doing to lower my cholesterol. I just couldn’t believe that I had to do it.

I’ve always had a diet high in dairy, so I switched to almond milk, and I lowered my intake of ice-cream (it’s my weakness). I doubled the length of my dogs’ walks, feeling proud that I was making all of us healthier.

And then I took another cholesterol test six months later. It hadn’t budged.

So I started taking statins (cholesterol meds).

Fortunately, I had no side effects (they’re not very common), and my cholesterol dropped down to normal in six months. I added dairy and ice-cream back into my diet because... why not? — everything was going well.

Everything was going so well, in fact, that I decided that I didn’t need cholesterol medication anymore.

After all, I’m skinny and I’m 38, and if the cholesterol medication worked so quickly, then there was no reason why I shouldn’t start taking it when I’m 50 or maybe even 60, when heart problems are more likely.

I quit, without the approval (or knowledge) of my docs. My cholesterol jumped back up again immediately. And then I got yelled at by my father and by my doctors.

Apparently, my logic was a bit off.

“If you’re already at a healthy weight and eating a healthy diet, you’ll usually need to be put on statins to manage cholesterol levels,” says David Albert, cardiologist and chief medical officer of AliveCor, explaining why some people with genetic cholesterol components simply need the meds.

High cholesterol can also do long-term damage, even if you’re able to lower it immediately with medication.

So yes, I could stop taking it for 10 years, but the damage that I would be doing to my body during that decade would be much more significant than if I didn’t take my meds.

My body would be storing all the extra cholesterol in my blood vessels, making the openings smaller and decreasing my blood flow. And if my blood flow got blocked, then my organs wouldn’t get nutrition or oxygen.

This could all lead to heart attacks and strokes, Besser explains further.

“Additionally, this cholesterol that is lining the walls of the vessels can break off and float further down the blood stream until it gets stuck,” Besser says. “When that happens — it’s called an occlusion — there is a sudden lack of oxygen to the area. This can cause a lot of damage to the part of the body fed by the blood — back to heart attack or stroke or damage to the organ affected.”

So, essentially, I’m on meds for life

There’s no amount of exercise, diet, or healthy lifestyle that will change this outcome.

It really makes me rethink society’s assumption that overweight bodies are automatically unhealthy — and vice versa.

We could all have health problems at any size, and we might not even know it. A cholesterol screening never crossed my mind (I’ve actually never been sick in my entire life, so this cholesterol test was part of my first visit to the doctor for a first-time check-up), but I’m oh-so-grateful for it.

I’m also okay with being on the meds. It’s all part of staying healthy despite my medicine cabinet now looking like one owned by an 80-year-old. But perhaps, now I’ll survive to be 80.

I can live with that.


Danielle Braff is a former magazine editor and newspaper reporter turned award-winning freelance writer specializing in lifestyle, health, business, shopping, parenting, and travel writing.