It will eventually throw a pup or two from the bottom which will grow nice and fat if given appropriate conditions. The skinny part never really will fatten up to catch up with the top. This happens from periods of too little light usually. I would cut it once it pups from the base and cut the fat part of the tip and re plant it.
He looks plenty healthy, just a wylie cactus. Plants will occassionally have a malformation every now and then... and like nicechrisman said, it is skinny becuase it needs more light.
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