The perils of being ‘skinny fat’.

I’ve been called many things in my life, but I wasn’t expecting this.

But being ‘skinny fat’ or TOFI (thin on the outside, fat on the inside) is a real phenomenon.

I just never thought it would apply to me.

 

What is ‘skinny fat’?

It’s where you’re at a healthy weight, but you’re carrying too much visceral fat, the fat you can’t see because it’s inside your body snuggled around your organs.

How much is too much?
Ideally, we should have around 10% or less of our total body fat as the visceral variety.

It’s different from subcutaneous fat, the fat we pinch between our fingers while mourning the fact we are getting heavier and have created more generous fat pads on our hips, thighs, tummy and butt than we would like.

Visceral fat is considered bad for our health, not just because it’s an indication our diet may need an overhaul, especially if you’ve got a sweet tooth and penchant for fast food but because it’s associated with an increased risk of heart disease, type two diabetes, high cholesterol, colorectal (bowel) cancer, Alzheimer’s and stroke.

The big difference being that visceral fat is metabolically active, meaning it’s releasing inflammatory proteins and hormones into the bloodstream. This can cause damage to your blood vessels and affects organ function.

It increases your risk of heart disease because it’s linked to higher levels of LDL (the so-called bad cholesterol) and triglycerides, lower HDL and raises blood pressure.

It promotes greater metabolic dysfunction by lowering insulin sensitivity because it breaks down very easily, releasing fatty acids directly into the liver and pancreas and increases your risk of developing type two diabetes.

 

How to measure visceral fat

There are scans (MRI or DEXA) that can give a precise indication, but you don’t need to commit to that expense.

A tape measure is all you need to give you an idea.

For women, having a waist greater than 35 inches is a warning sign.
For men, it’s having a waist greater than 40 inches.

People of Asian origin have lower criteria, 31.5 ins for women, 35.5 ins for men

 

Lowering visceral fat with lifestyle 

The good news here is that you can get rid of excess visceral fat quite easily, and no, you don’t need to spend hours at the gym or starve yourself.

Essentially, it’s about tweaking your lifestyle to improve your overall level of fitness, lower any insulin resistance and improve your metabolic health.

Being told I was TOFI was a wake-up call to more closely examine what I needed to be doing differently.

Because I’m in the healthy weight range, I don’t drink alcohol or smoke and follow the Mediterranean Diet pattern of eating I had become complacent about the other factors that were silently disrupting my metabolic well-being.

Oops, yes, even lifestyle physicians aren’t perfect. Sigh.

 

1. Diet

We all need to eat and preferably to include more healthy options – more fruit and veg, more fibre, sufficient protein and to avoid ultra-processed foods and excess sugar.

I don’t have a sweet tooth but have been underdoing the protein and fibre my body needs. It’s time to make some small changes to increase these. Pass the sauerkraut please.

Because I don’t need to lose weight, this isn’t about reducing calories, it’s a metabolic reset.

 

2. Exercise

As I wrote about recently, our muscles are our powerhouse for greater strength, driving glucose from the bloodstream to where it’s needed for energy.

I do resistance/strength training for an hour twice a week, walk twice a week and kayak once a week.
This needs to be increased to include more cardio and perhaps an extra session of resistance training.

The other thing to work on, is to increase the amount of incidental movement across the day.
Much of my work is done sitting at a computer in my home office, meaning I’m essentially sedentary.
So now I’m going to ensure I’m getting up every 60-90 minutes to do some squats and walk around the garden more.

 

3. Sleep

I’m very fortunate in that I sleep well and so long as I get my eight hours, I’m good to go. Poor sleep is metabolically damaging because it raises cortisol (stress hormone) while elevating ghrelin the hunger hormone and lowering leptin, the satiety hormone. Poor sleep essentially drives weight gain which can also lead to greater visceral fat accumulation.

 

4. Alcohol

If you regularly drink alcohol, you’re making your liver work harder because it prioritises processing this first. This can promote what is called fatty liver and elevates levels of triglycerides in the blood.

Try to reduce your alcohol intake or give it up.

This is because even moderate alcohol consumption means you’re taking in excess calories with no nutrient value and a reason why your waist circumference is getting bigger.

 

5. Stress

Oh dear.
The bad news is that visceral fat has a high density of cortisol receptors. Cortisol promotes fat storage. You can see where this is going ( straight to your waist).

We all get stressed.
Some of us stress more than others, meaning we have to learn ways to effectively manage that stress to the best of our ability. This is where developing several strategies to lower stress is vital.

This could look like:

• An early morning walk in nature
• Meditation
• Breathwork
  Listening to calming music
• Taking time out to relax
• Yoga or Tai Chi
• Gardening
• Doing something creative like pottery or artwork
• Singing
• Spending time with those who make you feel good
• Reducing negative input like the Bad News in our media
• Avoiding overwork or getting caught up in worry that you have no influence over.

 

Your metabolic health is vital to your overall health and well-being and longevity.

Making some small changes to your lifestyle now will pay dividends for your healthier future.

If you’ve been called ‘skinny fat’, what changes have you found effective to lower your visceral fat?

I’d love to hear your story.