LETTER | Some of the unhealthiest people look perfectly slim. They receive compliments about their figure, register a "normal" reading on the bathroom scale, and see nothing alarming in the mirror.

Yet beneath that exterior, something quietly damaging is taking place; their bodies are accumulating excess fat while losing the very muscle that keeps them alive and well.

This is sarcopenic obesity, widely known as being "skinny fat". It is neither rare nor trivial, and it is far more common than most people realise.

The term sounds contradictory. How can a person be simultaneously thin and obese? The answer lies not in appearance but in composition.

Body weight is simply the sum of everything inside us: bone, water, fat, and muscle. Two people can share an identical weight and yet carry vastly different proportions of each.

One may have strong, metabolically active muscles supporting a healthy frame. The other may have alarmingly low muscle mass concealed beneath a layer of excess fat.

On the scale, they look the same. In terms of health risk, they are worlds apart.

Importance of muscle mass

Think of it like a building with severe termite damage. From the street, it looks impeccable but the structure has been hollowing out from within.

Muscle is not merely an aesthetic concern for athletes. It is the body's primary engine, regulating blood sugar, sustaining metabolism, protecting joints, maintaining balance, and directly influencing longevity.

When muscle mass declines as fat accumulates, the body's efficiency deteriorates steadily. The long-term consequences are serious: increased risk of type 2 diabetes, cardiovascular disease, fatty liver, osteoporosis, and physical frailty.

For many, the danger arrives quietly, without warning, because the weighing scale never sounded the alarm.

This is the central flaw in how we currently approach health. We have become fixated on body weight as a proxy for well-being, while largely ignoring body composition, the factor that actually matters.

Lifestyle pressures

Modern life is, unfortunately, engineering this condition at scale. Many Malaysians spend 10 to 14 hours each day seated; in cars, at desks, in meetings, in front of screens.

Prolonged inactivity causes muscles to atrophy gradually. Meanwhile, caloric intake often remains unchanged or increases. The body slowly shifts its composition in precisely the wrong direction, and most people never notice.

Crash diets accelerate the damage. Losing 10 kilogrammes in a month sounds like an achievement, but rapid, unstructured weight loss frequently strips away muscle alongside fat.

The number on the scale drops. The person looks slimmer. But they have, in effect, removed structural pillars from their own body.

They become lighter and weaker simultaneously; more fatigued, more prone to aches, less physically capable, and more metabolically vulnerable as the years pass.

Younger generation affected

What was once considered a condition of later life is now appearing in younger adults. University students with sedentary routines, poor sleep, high stress, low protein intake, and no resistance training are increasingly presenting with early markers of muscle deficiency.

The human body was not designed to remain seated for most of its waking hours, and it is beginning to show.

Reversing this trend requires a fundamental shift in how we think about health goals.

The priority should be building and preserving muscle, not simply losing weight. Resistance exercise is essential: weight training, bodyweight movements, resistance bands, stair climbing, or even a daily routine of squats can stimulate muscle maintenance and growth.

It does not require a gym membership or hours of commitment. It requires consistency.

The second is nutrition. Muscle cannot be sustained on willpower alone. Many Malaysians consume diets heavy in refined carbohydrates but insufficient in quality protein.

Without adequate protein, the body cannot maintain the muscle it has, let alone build more.

The third is reducing sustained inactivity. Standing periodically, walking during phone calls, taking stairs, and breaking up long stretches of sitting are small habits that accumulate into meaningful protection over time.

And finally, we must stop treating thinness as a health credential. A person can be slim and metabolically unwell. Another may carry a few extra kilogrammes while being physically strong, metabolically healthy, and far more resilient. Appearance alone tells us very little.

Perhaps it is time we retired the question "How much do you weigh?" and replaced it with something more honest: "How strong is your body?"

Because in the end, it is strength, not slenderness, that determines how well we age, and how long we thrive.

The views expressed here are those of the author/contributor and do not necessarily represent the views of Malaysiakini.