TOFI

So, they have the wrong thing.

But we have seen Over the years, all these patients who they're called TOFIs, they're thin on the outside.

And at first, they have relatively high A1Cs or diabetes.

And I didn't believe it.

And so it goes ectopically to the viscera, to the liver, to muscle, and that's what causes diabetes.

And the people with lipodystrophy, they have diabetes as teenagers.

But what about these TOFIs? And sometimes we get some genetics back, partial lipodystrophy.

I don't know exactly what it is, but it kind of hit me.

Don't trust my opinion or anyone else's.

Also, you may wanna print out these studies if you go to your doctor as a s- as a slender person or a skinny person, and your doctor refuses to order these lab tests, then you can show them this study and say, "Hey, what if I'm TOFI? Thin on the outside, fat on the inside.

I really should know that because that's a, that's a huge risk for my future health, right?" Please consider clicking that subscribe button and a little bell button right beside it so that every time I post a new video, you'll be one of the very first people to know.

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So this person kind of looked okay from the outside but internally had high levels of body fat.

That's known as TOFI.

Thin on the outside, fat on the inside.

TOFI.

Also quite a lot of physical ailments.

Low back pain, knee problems, ankle problems.

so, uh, but I, I expect that, like...

Uh, like, is Tommy Tofi healthy? What's going on there? Like, is he gonna play this week? Like, I think if, if he's out there especially, I think it would make a lot of sense early on the road, sold-out crowd, like, take the air out of the ball a little bit.

Like, I understand that you wanna, you wanna create explosives through the passing game.

Do it off a play action after establishing a run game that's tough to stop, you know what I mean?

Sometimes it seems like what, what does come out is misinformation and maybe deliberate misinformation.

So there's, there was a lot of talk about who was gonna be in the... and including by us, based on stuff we were hearing about who was gonna be in the rotation and who wasn't, right? And, um, I think the latest that my thinking was, QB, coming into this game was that neither Ferguson nor Bennett were gonna be in the rotation, and they both were.

Um, and that Tofi was definitely gonna start somewhere and he didn't play a snap.

Um, [chuckles] and then, you know, seemed to be Addison or, or f- or Crater at left tackle and they both started and, and played the whole game.

And Dr. Sean O'Mara, who, again, I mentioned before, he's a pioneer in the U.S. of actually bringing this to his – But actually, the research predates him.

It was actually started from as early as 2010, where a bunch of English researchers used MRI in a pretty pivotal paper to make this point that It's a very simple paper to read, but they were the ones who, I believe, coined the term TOFI, thin on the outside, fat on the inside, to show that someone with a BMI of 24 can have a whole bunch of visceral fat.

And in that paper, they had these really elegant, two really elegant figures.

One of them, they have nine people, and all these nine people have the exact same BMI.

Yes.

So the TOFIs, it's really hard for you.

Well, you cannot really know much unless you have really good eyes on or already like recognizing people like I believe I do now.

But as a radiologist and observing people as well.

But the TOFIs are the people that look like as if they are healthy.

And in fact, they are the... worst metabolic unhealthy population because the since they believe they are healthy they don't take any action right so they have they have zero they have very little subcutaneous fat you can't really pinch them at all But they have a lot of fat surrounding their heart, which is the epicardial adipose tissue, and or a lot of fat in their abdomen, which is the visceral fat.

And these are usually the people who are younger and they are having atrial fibrillation, which is related to inflammation.

Yeah.

Those who have hypermobility, Ehlers-Danlos syndrome, et cetera, those folks either tend to be really thin and TOFI, thin on the outside, fat on the inside, completely deconditioned and thin.

And their tissues are very, I don't know how to describe it, but if I had to do a breast augmentation, I'd probably put mesh in there too.

I wanted to put mesh in their shoulders.

Yeah, I do.

It's the TOFI.

Uh, just look on YouTube for T- T-O-F-I, thin on the outside, fat on the inside.

Doc, I just started carnivore.

Where do they fit here?

We call them TOFIs.

So to look at them, you'd think that they have to be pretty healthy 'cause they're slender, but they have something like non-alcoholic fatty liver disease and/or type 2 diabetes.

And when we look at these individuals, we, we call them that, TOFIs, thin on the outside and fat on the inside.

And what does that mean? These individuals have a lot of visceral fat and not very much subcutaneous fat.

Now, subcutaneous fat is the fat that lies between top of your skin layer and your abdominal cavity.