Visceral Fat Loss Linked to Lasting Cardiometabolic Benefits Despite Weight Regain

Long-term follow-up of two randomized lifestyle intervention trials found that reducing visceral fat—not simply losing weight—was strongly associated with sustained cardiometabolic health benefits, and every 10% reduction in visceral fat lowered the future risk of type 2 diabetes by 28%. Researchers followed 366 participants from the 18-month CENTRAL and DIRECT-PLUS trials for 5–10 years after the interventions ended in Israel. Although most participants regained all of the weight they had lost, they maintained part of their reductions in waist circumference and abdominal fat depots, including visceral, deep subcutaneous, and superficial subcutaneous fat. In contrast, reductions in liver fat were completely reversed, while pancreatic fat not only returned but exceeded pre-intervention levels. Importantly, greater intervention-induced reductions in visceral fat, superficial subcutaneous fat, and pancreatic fat were associated with better long-term insulin resistance, metabolic syndrome severity, and overall cardiometabolic risk scores, even after accounting for weight change, diet adherence, and physical activity during follow-up. Among all fat depots, visceral fat loss emerged as the strongest independent predictor of durable metabolic health and a significantly lower incidence of type 2 diabetes, underscoring the importance of targeting abdominal visceral fat through diet and exercise interventions rather than focusing on body weight alone. Source: https://www.ahajournals.org/