TOFI Risk Assessment · 5 Questions · ~90 seconds
Are you Thin Outside, Fat Inside?
The TOFI phenotype — Thin Outside, Fat Inside — describes adults who appear lean by standard external measures but carry significant fat around their internal organs. This assessment uses five risk factors from published body composition research to help you understand whether your profile is consistent with the TOFI phenotype. It is not a medical diagnosis.
Question 1 of 5
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Question 1 of 5
What is your current BMI range — and does it align with how your body actually distributes weight?
Context: The WHO recommends a BMI threshold of 23 (not 25) for overweight in Asian adults, reflecting earlier metabolic risk onset at lower body weights.
Question 2 of 5
What is your ethnic background?
Context: Multiple large studies — including the Singapore Chinese Health Study and comparative body composition research across East and Southeast Asian cohorts — have found that people of Asian descent accumulate visceral fat at lower BMI levels than Western populations.
Question 3 of 5
How would you describe your daily activity pattern — not exercise, but the baseline movement of your typical day?
Context: Prolonged sedentary behaviour has been independently associated with visceral fat accumulation in cohort studies, separate from total body weight and exercise habits.
Question 4 of 5
Do you have a family history of type 2 diabetes or metabolic syndrome in close relatives?
Context: First-degree family history of type 2 diabetes is associated with increased susceptibility to visceral fat accumulation and insulin resistance, independent of overall body weight.
Question 5 of 5
Have you ever had a direct measurement of your body composition — DEXA scan, MRI, or a body composition scale — and if so, what did it show?
Context: Standard BMI and visual assessment are unreliable proxies for visceral fat. Waist circumference and waist-to-height ratio (above 0.5) are the most accessible validated proxies used in clinical practice for Asian populations.
Lower TOFI riskHigher TOFI risk
About this assessment: The five factors used here are drawn from published body composition research, including the work of Professor Jimmy Bell (Imperial College London), the Singapore Chinese Health Study, and WHO guidance on BMI thresholds for Asian adults. This tool is for general educational awareness only. It is not a medical diagnostic instrument. A definitive assessment of visceral fat requires clinical imaging (DEXA or MRI).