The Problem With TOFI

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[brookealiasemeraldfox]

100 percent! I love how you call things out as they are. I was twenty to thirty pounds over 'doctor standards' my whole life but was a very healthy teen and young adult taking no medications! Active, too. The myths or rather misunderstandings, surrounding the standard BMI chart have always driven me up the wall! It's like they don't want to look at anything else. It makes a LOT more sense to say someone is 'healthy' or 'not healthy, ' as a healthy overweight person should not be considered unhealthy- nor their weight noted in any kind of a chart.

[katarinasimeone]

I agree!! I have a older friend and looks like she’s in good shape and has type 2 diabetes. I couldn’t figure out how she got type 2. Even asked if it was in her family history. So does this mean she can fix it still with the keto diet?

[yahooyates]

Hi Amy, is there a good list of blood tests we can do to monitor our metabolic health?

[Alec_Collins]

TOFI describes what's literally going on if you have fat on the inside. I don't see a problem.

[paulaprice]

If you’re larger but still metabolically health, good for you. That may change with time. But something I really don’t see mentioned, really ever, are what I call, the mechanics of the body. Almost 10 years ago I had a bi-lateral knee replacement. Not only were they bone on bone, but I had crumbling bone. I can’t begin to describe how painful all that was. I then lost a lot of weight on Weight Watchers, and then gained a lot of it back, and that horrified me. Slowly re-losing on keto / carnivore. 22 more pounds to go. My point, all the excess weight is extremely damaging to the joints. I do not want another knee replacement. Also, I’m getting to the age where they might not even do it. If you’re metabolically healthy or not, think of your poor joints. I was in a wheel chair a lot, now I’m not, and don’t want to go back to it.

[StarvingMyselfToLIFE]

But shouldn't we also be including what's likely to occur if the fat on the inside isn't reversed? Metabolically healthy today really means nothing if you're putting yourself at high risk for problems down the line? Also, being "metabolically healthy" today could be because current tools aren't enhanced enough to actually see the beginnings of disease...yet. In other words, in the not so distant future, what we now consider stage 1 cancer may be considered stage 4 as equipment and detection improves.

[chazwyman]

Why get hung up on categorical problems? There are people who have lots of fat on their organs but little on the outside, and this does not carry any assumption that fattiness a cause of disease. What is true is that the TOFI type is significantly problematic as they have no clue that they might be ill because they look good on the outside. And yes there are fat people who are metabolically healthy, but it is still true that carrying that extra weight is eventually going to cause problems. Weight does "come into it, " as it is a massive predictor of metabolic ill health. And all who carry extra weight would do well to keep an eye on their bloods.