If it really is what‘s on the inside that counts, then a lot of thin people might be in trouble. Some doctors now think that the internal fat surrounding vital organs like the heart, liver or pancreas — invisible to the naked eye — could be as dangerous as the more obvious external fat that bulges underneath the skin.

According to the data, people who maintain their weight through diet rather than exercise are likely to have major deposits of internal fat, even if they are otherwise slim. “The whole concept of being fat needs to be redefined,” said Bell, whose research is funded by Britain‘s Medical Research Council. “Just because someone is lean doesn‘t make them immune to diabetes or other risk factors for heart disease,” said Dr. Louis Teichholz, chief of cardiology at Hackensack Hospital in New Jersey, who was not involved in Bell‘s research.

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