One of my duties as a diet counsellor and nutritionist is to continually keep myself informed about the latest findings in the dieting and food arena.
I need to be constantly reading learned articles, discussing various facets of diet with my work colleagues and watching hundreds of hours of lectures by other experts in the field. It can certainly be a demanding and thankless task doing all of this research, but I see it as an important job that has to be done.
It was While doing this research, that I came across a very strange phenomena called TOFI, which stands for Thin on the Outside, Fat on the Inside. This describes the person who may look thin to the naked eye, but in reality they are carrying dangerous amounts of visceral fat around their abdominal organs.
One well known gentleman who was found to have this syndrome was Doctor Michael Mosley who wrote the 5:2 diet book.
Mosley had always considered himself trim and healthy, but his vital organs were enveloped in layers of fat. He was a TOFI. People identified as TOFIs are often of normal weight and just have a bit of “middle-age spread”. What they don’t know is that there is a load of fat around their organs which sets them up for illnesses like diabetes, cancer, dementia and heart disease.
Doctor Mosley had an MRI and that showed that his internal organs were swimming in visceral fat. This shocked him so much that he started investigating intermittent fasting, trying fasting for several days at a time, before settling on a regime of eating normally five days a week and cutting his kilojoule intake for two.
Mosley is passionate about alerting people to the dangers of visceral fat and advises anyone who fears they may be a TOFI to measure their waists. The first thing you should do is get a tape measure and measure yourself.
Many studies seem to point to a target waist to height ratio of approximately 0.5 to be in the clear for high visceral fat levels. However a person with known genetic or hereditary risks would probably go to their GP to get their blood sugar and cholesterol levels looked at.
Too lazy to calculate your own Waist to Height Ratio? Then use the handy calculator at this site:
Waist to height ratio is a simple measurement for assessment of lifestyle risk and overweight. Compared to just measuring waist circumference, waist to height ratio is equally fair for short and tall persons. This calculator is valid for children and adults.
Wikipedia tells us that the term TOFI, “thin-outside-fat-inside” is used to describe lean individuals with a disproportionate amount of fat stored within their abdomen.
It goes on to state that subjects defined as TOFI with BMI <25 have increased levels of many of the risk factors associated with the metabolic syndrome.
The more technical term for these people is metabolically-obese but normal-weight (MONW).
So what do we do if we are a TOFI? Obviously you are going to need to change your diet and lose some of that hidden visceral fat. Lets listen to what Doctor Mosley has to say:
And a handy summary of the book:
So you “thin” people don’t get too cocky! There might just be a fat person inside you looking out!