Oh Yeah! There is a condition called Metabolically Obese Normal Weight (MONW). It is synonymous with Thin on the Outside and Fat on the Inside. Also known as TOFI.
How can being skinny and obese happen?
There are different kinds of fat. The subcutaneous type is the one under the skin and can get thick and manifest as obesity. The subcutaneous fat is known to be metabolically stable. Meaning it does not produce substances that can cause inflammation to the whole body.
Fat inside the abdomen is called visceral fat. The visceral fat is located in two areas. The first is in the omentum. The omentum is like an apron that hangs from the stomach and the transverse colon. If the omentum starts to accumulate fat, then it gets thick. That is what bulges out in “beer bellies” or “soda pop bellies.” The subcutaneous fat also adds to the bulge in that situation. The accumulation of omental fat is harmful because it can secrete toxic substances called pro-inflammatory cytokines that cause chronic illnesses like atherosclerosis and cancer.
The bigger problem is when fat accumulates in the liver, called the fatty liver. Three things can cause fatty liver. When there is a constant supply of high blood glucose, and the liver is filled up with glycogen, the liver will try to maintain a healthy blood sugar such that it sacrifices itself and changes the glucose into fat which is a denser form of energy and it stores it in the liver.
The second is fructose overload. Fructose comes from table sugar, which is sucrose. Sucrose is 50% glucose and 50% fructose. High-Fructose Corn Syrup or HFCS contains more fructose from 55 to 65%. It is in pop, bread, catsup, sauces, and most the processed foods.
The third is alcohol, which is metabolized, just like fructose in the liver. There is a big difference between fructose and glucose metabolism.
The Difference between Glucose and Fructose Metabolism
After ingesting glucose, 80% is used by the body for normal body function. Only 20% of glucose goes into the liver to make glycogen. In contrast, 100% of the fructose goes to the liver. While the liver can metabolize part of the fructose into glucose, if sugar and HFCS consumption is high, then the liver becomes fully loaded right away with glycogen. Fatty infiltration of the liver leads to insulin resistance and then high blood sugar.
How Fat Inside the Abdomen Develops
If the high sugar, starch, and HFCS consumption continue, glucose becomes fat and spreads in the blood as VLDL or triglycerides. The fat cells then get deposited in the other organs in the abdomen, including the pancreas, leading to diabetes. The thickened omentum later secretes inflammatory substances. A sedentary lifestyle is a significant risk factor in the development of the fatty liver.
Fatty liver and hyperinsulinemia are the cornerstones of metabolic syndrome.
The “At-Risk Obese” and Metabolically Healthy Obese
This classification applies to a person who has a high BMI (>25), high visceral fat content, high-fat mass, high blood sugar, low insulin sensitivity, high triglycerides, and low HDL. 80% of people with high BMI have this.
There is also a Metabolically Healthy Obese (MHO). They have a high BMI and high-fat mass, but normal to a high level of insulin sensitivity, low triglycerides, healthy blood sugar, and high HDL. They account for 20% of the obese population.
Summary:
Being a TOFI can also lead to insulin resistance, high blood sugar, diabetes, abnormal lipid profile, atherosclerosis, heart disease, and cancer. Just because you have an average weight does not always mean you are healthy. TOFI can also be seen in children.
Related Readings:
- How Will You Know if You are TOFI?
- Can You be Skinny and Obese?
- What Does Waist Circumference Really Measure?
- Why Do Bellies Bloat?
Photo Credits: Wikipedia. Public Domain
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