TOFI syndrome, otherwise concealed obesity is a metabolic disorder that involves the accumulation of large amounts of adipose tissue in the abdominal organs and not directly under the skin. Therefore, people with TOFI syndrome seemingly slim, inside are obese. How is the TOFI syndrome diagnosed and treated? 

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The name of the syndrome – TOFI – is a shortcut from English, from the first letters of the words thin outside – fat inside, i.e. lean from the outside, and obese in the middle. TOFI syndrome consists in the fact that the body stores fat tissue, but not under the skin, only inside the internal organs and in the spaces between them. Thus, people with TOFI syndrome, although they have normal weight, their internal organs are very obese.

The development of hidden obesity is caused primarily by poor nutrition – eating too abundant in trans fat and saturated fats and simple carbohydrates (eg products with sweeteners), but also eating meals at abnormal times – eg avoiding breakfasts for abundant dinner. 

TOFI syndrome occurs when the fat content in the body is over 20-25 percent in men and over 30-37 percent in women. TOFI syndrome is very difficult to diagnose because it can not be seen and does not give any symptoms. The thickness of subcutaneous fat and the adiposity of internal organs can only be properly examined by computed tomography and the so-called DEXA1 methods (1 DXA – dual-energy x-ray absorptiometry) allowing automatic calculation of the mass and volume of adipose tissue in the abdominal region. Simpler, though not so reliable, method is blood test – morphology, lipidogram (LDL cholesterol, HDL cholesterol and triglycerides), glucose and insulin. If the level of any of these components deviates from the norm, consider further diagnostics for TOFI syndrome. Especially when you notice that despite the slim figure, especially a lot of fat accumulates around your waist and neck. 

The fat that accumulates around and inside the internal organs is much more harmful than the fat stored under the skin. It is he who transmits chemical signals to the brain that lead to insulin resistance and inflammation in the blood vessels. As a result, thin people with TOFI syndrome are more likely to suffer from chronic diseases being complications of obesity than people with visible overweight and obesity. 

Internal fat can lead to the development of such serious diseases, including metabolic syndrome, hypertension, lipid metabolism disorders, insulin resistance and type 2 diabetes, pancreatic diseases, non-alcoholic fatty liver disease, cardiovascular disease and heart attack. 

In the concealed obesity therapy, as in the case of visible obesity, the proper diet and physical activity are crucial – individually matched to the condition and needs of the patient. Diet should not be too restrictive, but it should exclude trans fat and saturated fat, sugar, sweets and sweeteners and alcohol, limit fruit intake, and increase the amount of raw vegetables, cooked, baked or in the form of creamy soups. It is necessary to control the number of calories daily delivered with meals to maintain a correct, or zero, energy balance. If you take in the same amount of calories as you lose moving (eg at home and professional activities, doing exercises, doing sports), you will have no problem with TOFI syndrome. 

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You can read also: Diet and exercise as one of the main ways to lose body fat

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