TOFI – Thin on the Outside, Fat on the Inside

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.


Could the tight jacket be hiding a beer gut? Too close to call from this picture.

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!


  1. Hi, I am really trying hard to lose weight and since starting on your diet I have dropped about five kilos.

    I have a high sex drive and I cant wait to lose more weight and really get stuck into some hot sex with attractive male partners. I am a very big believer in the idea that I won’t know if I like something unless I’ve tried it a couple of times.

    My girlfriends tell me that some of the most fun they have had was when they tried something they were not 100% convinced they would enjoy was going to enjoy.

    I know I have ideas that I want to try it with a partner I trust, but sometimes because of my weight, I will do it with anyone who is available and sometimes they won’t stop if you change your mind about something anyway.

    Because it’s all right to not like something and ask to stop, too. But letting my insecurity about my body should not stop me from trying ANYTHING, I don’t want to limit my fun. I say, just go at your own pace.

    But what, you might be wondering, can people who want to have sex with fat people do? How can you as a person who wants to get it on with a fatty improve your relationship and your chances? It’s for the best that you’ve asked.

    We are all trying to lose weight and want to be slimmer and more attractive. But we are humans and have the same needs for regular intimacy and sex as our thin friends.

    So lose weight, get fit, get thin, but don’t pass up the opportunity for sexual experiences until you have a perfect figure and a bikini body


  2. Hi, I agree with most of the article but its important to remember as I have told my friends many times, the idea that all your problems are solved when you lose weight is false, false, false. When weight comes off you will have exactly the same feelings you have now. Yeah maybe you will temporarily feel excited, relief, etc. But, trust me that will only last a very short time and then all those old feelings creep right back in.

    So what I am getting at is that we fatties need to lose the weight, but we also need to be looking ahead to life after weight loss. Work on that self-esteem and have a few good hobbies ready to take up when you are fitter, slimmer and more attractive.

  3. Yet to admit any of this is to show weakness, to be embarrassed. In our attempts to be successful, to gain parity with our male colleagues, we pretend that menstruation doesn’t exist. But if grown up women don’t talk about it, what message are we sending to teenage girls and young women such as Watson who have to contort themselves with euphemisms such as “girl things”? Eating bananas may or may not help menstruation but at least they taste great and you can always use them internally if that rings your bells.

  4. Another great article.

  5. Ha Ha! I am fat on the inside and the outside. Great article though.

  6. christian louboutin

    Hans, this is another great article from you. Thanks, keep them coming.

  7. Yep, that’s me TOFI…it does count if I’m fatter on the inside right? I’m only a few stone over weight!
    On a serious note, I had a friend who was so slim she was grateful when the UK brought out a size 4 but could eat 5 double cheese burgers as a snack. Her organs must have so much fat on them!

  8. Hans half brother

    Excellent article.

  9. I agree with it, they are probably not the healthiest things but they are pretty tasty in my opinion.

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