Thin Physique with Unhealthy Body Composition: Explaining the Concept, Causes, and Lifestyle Adjustments Needed
Skinny fat, also known as "normal weight obesity" or "thin outside, fat inside (TOFI)", is a concerning health condition that has been gaining attention in recent years. This condition refers to individuals who have a higher proportion of body fat than is healthy and lower than ideal lean body mass, making it less visible and more difficult to diagnose.
People with skinny fat may be at risk of cardiometabolic diseases such as heart disease, type 2 diabetes, heart attack, stroke, and diabetes. These diseases are often associated with obesity, but the misleading appearance of individuals with skinny fat can make their condition overlooked, increasing the risk of complications.
A 2023 cross-sectional study found that people with skinny fat consumed ultra-processed foods (UPF) and beverages with added sugar more frequently than those without skinny fat. UPF is defined as food prepared in an industrial setting, containing at least five ingredients such as sugar, oils, fats, salt, antioxidants, stabilizers, and preservatives. Examples of UPF include ice cream, chocolate and candy, mass-produced packaged bread, margarine and fat spread, cookies, pastries, and cakes, chicken nuggets and hot dogs, preprepared pies, pasta, and pizza.
The role of diet in skinny fat is significant, with an unhealthy diet being one of the environmental factors contributing to the condition. Other factors include lack of physical activity, smoking, alcohol consumption, and potentially certain gene variants in South Asian populations.
To focus on fat loss, a person needs to take in fewer calories than they use. The ISSN recommends that losing weight more slowly preserves lean body mass in leaner people. Making dietary adjustments, such as limiting or avoiding UPF, may help a person improve their body composition.
Improving diet, increasing physical activity, and using metformin (recommended and prescribed by a healthcare professional) could potentially help prevent and treat TOFI. However, people with a MONW body type do not have specific treatments. They tend to receive the same treatment as people with metabolically unhealthy obesity, which involves lifestyle modifications and appropriate management for any underlying health conditions.
Signs of being skinny fat may include excess fat tissue around internal organs, fat deposits in tissue that normally does not contain much fat, fat tissue inflammation, altered inflammatory and metabolic profiles, reduced skeletal muscle mass, and low cardiorespiratory fitness. Smoking and alcohol consumption may increase the risk of skinny fat, and stopping these habits may help reduce it.
Studies have shown a significant rise in cases of type 2 diabetes over the past few years, with researchers predicting a continued increase. Given the association between skinny fat and cardiometabolic diseases, understanding and addressing this condition could play a crucial role in reducing the burden of these diseases.
In conclusion, while skinny fat may not be immediately apparent, it is a significant health concern that requires attention. By making informed dietary choices, increasing physical activity, and addressing other lifestyle factors, individuals can work towards improving their health and reducing their risk of cardiometabolic diseases.
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