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What is skinny fat?

This month in Santé you can read the story of Esmir, who tackles her skinny fat. But what exactly is skinny fat?

The slimmer, the healthier? That's not always true. Even if you are slim, you can carry invisible fat with you. This phenomenon is called TOFI:Thin Outside, Fat Inside.

Are you a lucky guy who can eat everything without gaining an ounce? Or are you sometimes secretly jealous of such a person? Maybe there isn't much to be jealous of after all. Excess weight can sometimes be seen on the scale (and on your body), but not always. You can also be too fat on the inside without being confronted with jeans that are too tight. Skinny fat is the name of this phenomenon, also described as tofi:thin outside, fat inside. Thinner people may just as well be at risk for conditions often associated with overweight and obesity, such as high blood pressure, cardiovascular disease and type 2 diabetes.

Fat between the organs Professor Jimmy Bell of London Imperial College put 800 Britons under an MRI scanner and discovered that many people who had a normal BMI had a lot of fat hidden between the organs. This is called visceral fat, and is more harmful than subcutaneous fat that is stored directly under the skin. For example, MRI scans of sumo wrestlers show that they have a thick layer of bacon under the skin, but that there is hardly any fat between their organs, which means that they run fewer health risks than you would think based on their weight and diet of 5,000 kilocalories per day.

Internal fat is unhealthy, but why exactly, there are different theories. A lot of research is being done, but unfortunately no clear cause has yet been discovered. It is plausible that internal fat is especially harmful to the liver. Fat is continuously broken down and enters the bloodstream to be used elsewhere as an energy source. Blood from the tissue directly under the skin, basically goes to the heart and lungs. But blood that comes from fatty tissue between your gut and other organs goes straight to the liver. As a result, they are exposed to too much fat and that is not healthy.

In addition, researchers have discovered that adipose tissue in the abdomen produces substances that can lead to inflammation, which influences the immune system and hormones. One of the complications of having too much belly fat is that the body can become insensitive to insulin, making you more likely to develop type 2 diabetes.

Are you skinny fat? Whether you store fat under the skin, or whether you collect it between your organs, is not visible to the naked eye. The fat measuring device in the gym is also inconclusive. The only indicator with which you can get started is the circumference of your waist. Studies of people with the same BMI showed that one had more fat under the skin and the other deep in the abdomen. The latter, however, did have a higher waist circumference. It is unhealthy for men to have a waist circumference of more than 102 centimeters, for women the limit is 88 centimeters. So a healthy BMI does not say everything about whether you have a healthy weight.

You can read Esmir's story in the December issue of Santé.