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Fat On the Inside, Skinny on the Outside

Fat On the Inside, Skinny on the Outside

Tuesday 9th May 2023

Is it possible to look skinny but be clinically obese?

The phenomenon of being thin on the outside but fat on the inside, often called 'skinny fat' or TOFI for short. You've probably heard people boast, "I'm so lucky, I can eat whatever I want without putting on weight" but... is that really all that lucky? In a word: no. Ironically, it may be these thin individuals with dangerous levels of visceral fat that need to worry the most about their health.

These people can often carry on in cruise control with their lifestyle choices without knowing about the hidden dangers beneath their skin. A recent paper in the Annals of Internal Medicine reports that "Normal weight adults with central obesity (TOFIs) have worse long term survival rates than those with raised BMIs" WHAT ARE THE SIGNS OF TOFI? People who are TOFI are often of normal weight. However, they have low levels of lean muscle, but excess amounts of visceral fat. Excess levels of visceral fat is associated with Insulin
Resistance, which can lead to type 2 diabetes and heart disease as well as many other related diseases. TIPS:

From this, you can calculate your Waist to Hip ratio (WHR). Ideally, you want your waist to be smaller than your hips. Abdominal obesity is when your WHR is greater than or equal to 0.9 for a man and greater than or equal to 0.85 for a woman. IS THERE A TREATMENT FOR TOFI? The treatment for TOFI is often very similar to that for obesity. That is because the goal is not only to be a normal body weight, it is to be healthy and lean as well.

  • Check your triglycerides
  • cholesterol
  • fasting blood glucose
  • Body fat ideally less than 30%

Your NHS doctor can check these for you.

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Strength training can also be very useful for those who are TOFI. It increases lean muscle as well as improving insulin sensitivity. Simple bodyweight exercises such as press ups, step ups and squats can be highly effective.