Our Keto Journey Part 3: Defeating A Skinny Fat Body And Healing Chronic Fatigue Syndrome

This is part 3 of our series Our Keto Journey. In our last post, Barbara highlighted how a ketogenic diet helped her shed fat and is helping her guard against Alzheimer’s Disease. However, as I mentioned in this post here, not everyone goes keto for the same reasons. Remember, a keto diet is high in healthy fat, moderate in protein, and very low in carbs (<30 net grams /day).

In my case, I wasn’t overweight, but I did have a metabolically dangerous visceral fat issue that required I go keto. Also, since the keto diet has potent anti-inflammatory effects, I wanted to see if it was possible for the diet to get me over the last hurdle of recovering from chronic fatigue syndrome (CFS).

Let’s first take a look at my use of a ketogenic diet for my fat problem.

A recent report found that the obesity epidemic in the United States is continuing to grow to unhealthy proportions. This means that tens of millions of Americans will continue to be at a high risk for diabetes, hypertension, heart disease, metabolic syndrome, Alzheimer’s disease, and many types of cancer.

But did you know that there are millions of individuals who don’t look obese, who are technically not overweight, but who are metabolically obese?

Medical researchers label these individuals as normal weight obese (NWO). You may have heard them characterized as having a skinny fat body type.

The problem for NWO individuals is that they are at the same high risk to suffer all the diseases associated with being severely overweight. Now before you think this is some small segment of the U.S. population, some researchers estimate that there may be up to 30 million Americans who fit this profile.

I’ll repeat that for emphasis. Up to 30 million Americans might be NWO.

The hidden danger for NWO individuals, though, is that since they’re normal weight, they don’t realize that they have a serious health problem. In fact, they are harboring a metabolic ticking time bomb waiting to explode into a severe disease at some future date.

As an NWO person, it was imperative that I change my body type. And here’s the good news. You can change your body type and improve health. And it doesn’t matter what age you are.

Read on to see how serious a health threat NWO is and how I defeated it.

What Is Normal Weight Obese (NWO)?

I’ve never been “technically” obese or severely overweight so I was spared the emotional trauma that accompanies this disease. But I did have a very serious problem with excess body fat.

Even though I was normal weight, I had an unhealthy amount of fat on my body compared to lean muscle. Individuals with this body type are termed normal weight obese.

Metabolically, it’s a very dangerous body type. As I mentioned previously, just like those who are severely overweight, we NWOs are at a higher risk for a host of metabolic diseases.

In fact, skinny fat people (the other term for NWO) might be even more unhealthy than overweight persons who have well-distributed weight and good muscle mass.

Do Only The Obese Have To Fear Body Fat?

By outward appearances, I always looked fit and trim. I wore clothes exceedingly well. But what those clothes masked was about 20-25 pounds of fat that resided right around my abdomen. Since that was the only place I was fat, my overall weight was usually normal as calculated by body mass index (BMI).

I also was not particularly lean. I did some weight lifting in my twenties, but at 30 years old I developed CFS. That stopped me from doing any intensive exercise. For the next 28 years, my muscle mass would remain poor in quality and I would even lose some muscle due to normal aging.

That excess fat around my midsection, though, meant that I was a particularly bad type of skinny fat. Now, I know God created me with abs. I believed they were in there somewhere, but for 60 years of my life, I never saw them.

What’s TOFI?

There’s another name that scientists also like to call us. It’s TOFI. That means thin on the outside, fat on the inside.

The problem with excess fat around the abdomen (also called central obesity) is that it’s often indicative of a dangerous type of fat, called visceral fat, deeper inside our bodies. The American Heart Association states that,

Regardless of your height or build, for most adults a waist measurement of greater than 94 cm [37″] for men and 80 cm [31.5] for women is an indicator of the level of internal fat deposits which coat the heart, kidneys, liver, digestive organs and pancreas. This can increase the risk of heart disease and stroke.

To complicate matters, with my big gut I had skinny legs and a small butt. This is known as an apple shape skinny fat. Sheesh, the name calling just keeps coming for us NWOs.

Research has shown that thin hips and thighs when accompanied with a large belly are predictive of an even greater risk for metabolic disease.

As you can see, we skinny fatties are a metabolic disaster waiting to happen. The scary thing, though, is that we don’t realize it.

In order to improve my body type and become healthier, I went on a low-carb diet. It helped, but it only took me so far. I still carried around too much belly fat. To get where I needed to be, I had to resort to radical means.

How Do You Get To Be Skinny Fat?

There are basically three things that must be present for someone to become skinny fat.

1. A poor diet – This means eating a lot of refined carbs, sugar, fructose, and seed oils (vegetable, corn, soy, etc.). Basically, it means consuming the standard American diet. Over consume that stuff, and you’ll gain weight, guaranteed.
2. A sedentary lifestyle – Leading the life of a couch-potato or a lack of devotion to strength training usually results in lack of lean muscle mass.
3. Genetics – The third factor necessary to be skinny fat seems to be something we have no control over. Recently, researchers have found that there is evidence that this body type is genetically determined.

That doesn’t mean, though, that just because a large part of this body type is genetic controlled, it can’t be changed. It requires hard work, but it can be done. And the rewards are certainly worth it.

I want to be around for my children’s weddings. I want to be there for my future grandchildren. And I want to enjoy my golden years with my wife. Therefore, my skinny fat body had to be transformed.

Before I get into how well the keto diet performed, let me give you some parameters on how doctors determine if an individual is at metabolic risk because of NWO.

How Do You Know If You’re Skinny Fat?

If a person is NWO and they already have symptoms of metabolic syndrome such as insulin resistance, diabetes, hypertension, dyslipidemia, or cardiovascular disease, they will use the term metabolically obese normal weight (MONW). An NWO person has an increased risk to become MONW but has yet to manifest overt disease.

However, determining what obesity actually is has been difficult for researchers. Classically, it’s defined as having too much body fat. However, the problem is what exactly is too much fat.

Can Body Mass Index (BMI) Determine Obesity?

In the past, body mass index (BMI) was thought to be a reliable indicator of obesity. It attempts to determine your risk for disease according to your height and weight. A BMI over 30 would place an individual in an obese category. Twenty-five to 30 would be overweight and 18.5 to 25 would be normal weight. You can calculate your BMI here.

However, there are several shortcomings of a BMI measurement. It ignores:

• Body fat percentage (BF%)
• Lean muscle mass
• Weight distribution.

This means that a person who has a BMI over 30 and is considered obese by BMI could theoretically be very healthy if they possess good lean muscle mass and good weight distribution.

On the contrary, you may have a normal BMI but be at risk for the complications of obesity like us TOFIs.

Body Fat Percentage

Medical researchers now focus on body fat percentage (BF%) as a better indicator of health. BF% is the total mass of fat divided by total body mass times 100. While there is no consensus on exactly what BF% constitutes obesity, researchers have proposed some guidelines.

The American Council on Exercise has suggested these parameters as acceptable BF%:

The Obesity Research Center at St Lukes-Roosevelt Hospital and Columbia University College of Physicians and Surgeons used the following BF% guidelines to establish obesity:

Other studies confirm these findings. This study which analyzed 6171 subjects greater than 20 years of age considered a BF% >23.1 in men and >33.3 in women as being NWO.

Another study of 4,489 subjects aged ≥60 years (BMI = 18.5 to 25) labeled men who had >25% BF and women who had >35% BF as being NWO.

From these sources, we can safely say that if you have a normal BMI but your BF% is ≈25% or greater, then you are considered NWO and thus at an increased risk for metabolic disease.

What Are the Risks Of NWO?

Several studies with large cohorts of individuals have consistently shown that NWO individuals suffer a greater risk for metabolic disease. See here, here, here.

This study of 6171 subjects found that individuals classified as NWO had a prevalence of metabolic syndrome 4 times higher than people with normal BMI and normal BF %.

Metabolic syndrome (MetS) is characterized by at least 3 of the following conditions: abdominal obesity, hypertension, high blood sugar, high serum triglycerides and low high-density lipoprotein (HDL) levels. MetS is also highly associated with diabetes and cardiovascular disease.

The study also found that women with a normal BMI but with the highest BF% (>33%) had about an 8 times greater risk of having metabolic syndrome and a 2.2 times higher rate of dying from cardiovascular disease.

If these results make you concerned about the amount of body fat you’re carrying around then that’s a good thing.

How Do You Determine Your Body Fat Percentage?

The easiest way to determine your BF% is to look at some images of people with their BF% indicated. That’s what I do. It’s not the most accurate but it’ll give you an idea where you stand.

You can also use this calculator here. But again accuracy is limited. These calipers will give you a better estimate of your BF%.

If you want to know your exact BF% you’ll have to have it professionally done. Remember you want it <25 if you’re a man and <32 for a woman.

Waist To Hip Ratio (WHR)

Remember, I mentioned before that I had a particularly bad type of NWO. My belly was large and my backside was small. This meant that my waist to hip ratio (WHR) was poor. This ratio is determined by dividing the circumference of your waist by that of your hips (W ÷ H).

Researchers now believe that this ratio gives a better indication of an individual’s risk for metabolic disease.

According to the WHO, a healthy WHR is:
0.9 or less in men
0.85 or less for women

This study done by researchers from Johns Hopkins University used the following guidelines to determine metabolic health risks associated with WHR.

What Are The Risks Associated With A High WHR And Normal BMI?

In 2015, the Mayo Clinic conducted a study on 15,184 adults concerning mortality risks on individuals with high central obesity as measured by WHR. This study was conducted over a 14 year time period. Their findings were astonishing.

A recent study of 42,702 participants also found that “when compared with the normal weight participants without central obesity, only normal weight and obese people with central obesity [measured by WHR ed.] were at increased risk for all-cause mortality.”

Okay, I think I’ve made it pretty clear. If you’re an NWO individual, if you have central obesity, or if you have a high WHR, you’re playing with fire. It’s not something you want to ignore. Your health risks are too high.

At one time my WHR was almost a 1. That meant I was at a high risk for metabolic disease. I had to do something about it.

My Transition To Keto

Here is a progression of my journey to a ketogenic diet.

My highest weight was 193 pounds. At that point, my waist was 40. This caused my WHR to measure at a whopping 1.05. As I said, I was a metabolic ticking time bomb. I hit these numbers shortly after going gluten-free (GF). At that time, manufacturers were just starting to make tasty GF products (bread, pizza, pasta, etc.), and I was devouring them like there was no tomorrow.

On the paleo diet, I ditched all refined grains (except rice), sugar, industrial seed oils, and processed foods. If I had forsaken rice and sweet potatoes, I probably would have lost more weight.

It was the low-carb diet, though, that caused significant amounts of fat to melt away from my abdomen. However, I eventually plateaued, and that’s when I went keto. You’ll notice that my hip measurement increased by 1 inch. After two years of barbell back squats, my legs have gotten tremendously stronger (for me :)) but I guess I just can’t put any fat on my backside.

Also, notice that I didn’t lose strength during my keto period. Initially, I did reduce some weight on bench press and deadlifts, but within a few months, I regained what I lost.

So, as you can see, in order to really get where I had to be I needed to make the leap to keto. I don’t think staying moderately low-carb would have gotten me there.

It was during the paleo phase that most of the energy I lost because of CFS was restored. A big thanks to Mark Sisson at Mark’s Daily Apple for introducing me to paleo.  That brings me to how keto could help my CFS.

Can Keto Help With CFS?

I developed CFS in 1986. It came on me literally overnight. Within 24 hours I had lost at least 60% of my energy levels. It took nearly 26 years to get back to 90 percent. The three biggest factors that helped me were daily walking, a reduction in stress, and the paleo diet. From what I’ve read, few people heal 100% from CFS. But I wanted to see if I could get to 100%.

Could the keto diet help get me there? I haven’t seen any studies suggesting it might, but theoretically it’s possible. Here’s why.

CFS Is An Inflammatory Disease

For years doctors told me I had inflammation going on inside my body. Like I didn’t know that. The fatigue, muscle aches, and early arthritic joint changes informed me of that every day. The experts said I must have some virus that we can’t detect. Nonetheless, I was chronically inflamed.

Doctors still don’t know what causes CFS, but a study released last year revealed that CFS is highly associated with an increased expression of inflammatory cytokines within the body. The researchers concluded, “Our findings show clearly that it’s an inflammatory disease.”

Now, in my first post in this series, I illustrated the potent anti-inflammatory nature of the keto diet. Would the keto diet be able to quell the inflammation still going on in my body? After being on the diet for 8 months, I can’t give you an empirical answer. But experientially I can say I’ve felt better than I have in 31 years.

CFS And Dysautonomia

About 90% of CFS sufferers have dysautonomia. I happen to be one of them. Dysautonomia is a dysfunction of the sympathetic and parasympathetic branches of the autonomic nervous system. Experts are not sure of the exact cause of the dysautonomia but there are 3 suspected ones. It’s either inherited, a result of some form of neurodegeneration, or it’s a result of an injury.

Now we know that a keto diet can help in conditions such as Parkinson’s and Alzheimer’s where neurodegeneration has taken place. Can the keto diet help me with my dysautonomia? The jury is still out on that but I will keep you informed.

That’s my keto journey. In our next post, I’ll walk you through exactly how we do keto.

Thanks for reading. I hope you have a blessed week. Don’t forget to leave a comment. We’d love to hear from you.

P. S. If you’re looking for low-carb recipes, get a copy of Barbara’s newly released eBook Bursting With Flavor: 50 low-carb and gluten-free recipes designed to delight your taste buds. This isn’t just any cookbook. It’s filled with her tastiest and healthiest recipes. You’ll be able to walk into your kitchen excited to easily cook a new meal each day.

Read this next

Our Keto Journey Part 4: How We Calculate Our Keto Diet Macros

Our Keto Journey Part 5: Important Tweaks We Made For Keto Success

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