For decades, body mass index (BMI) has been the standard tool for assessing obesity-related health risks. However, emerging research indicates that when it comes to brain health, BMI alone may be misleading. Neurologists now point to fat distribution—rather than overall body weight—as a more important factor influencing brain ageing and neurological disease risk.

Large MRI-based population studies reveal that internal or “hidden” fat, particularly fat stored around vital organs such as the pancreas, is strongly associated with accelerated brain ageing, loss of grey matter, cognitive decline, and increased vulnerability to neurological disorders. Alarmingly, pancreatic fat often goes undetected in routine health checks, unlike visible abdominal or liver fat.

Experts also highlight the risk faced by individuals often described as “skinny fat”—people with a normal or slightly elevated BMI who carry excess internal fat. Despite appearing lean, such individuals show brain changes similar to those seen in people with obesity, challenging the assumption that normal weight equals low health risk.

Internal fat can drive chronic inflammation, insulin resistance, and subtle vascular damage, all of which may silently impair brain function over time. Neurologists stress that protecting long-term brain health requires moving beyond the weighing scale, focusing instead on early detection of harmful fat distribution and personalised preventive strategies before symptoms appear.

For decades, body mass index (BMI) has been the standard tool for assessing obesity-related health risks. However, emerging research indicates that when it comes to brain health, BMI alone may be misleading. Neurologists now point to fat distribution—rather than overall body weight—as a more important factor influencing brain ageing and neurological disease risk.

Large MRI-based population studies reveal that internal or “hidden” fat, particularly fat stored around vital organs such as the pancreas, is strongly associated with accelerated brain ageing, loss of grey matter, cognitive decline, and increased vulnerability to neurological disorders. Alarmingly, pancreatic fat often goes undetected in routine health checks, unlike visible abdominal or liver fat.

Experts also highlight the risk faced by individuals often described as “skinny fat”—people with a normal or slightly elevated BMI who carry excess internal fat. Despite appearing lean, such individuals show brain changes similar to those seen in people with obesity, challenging the assumption that normal weight equals low health risk.

Internal fat can drive chronic inflammation, insulin resistance, and subtle vascular damage, all of which may silently impair brain function over time. Neurologists stress that protecting long-term brain health requires moving beyond the weighing scale, focusing instead on early detection of harmful fat distribution and personalised preventive strategies before symptoms appear.