Managing Cardiometabolic Risk

It is well documented that weight loss has a positive effect on all obesity-related metabolic complications (blood pressure, lipids, insulin sensitivity and glucose tolerance, inflammation, etc.). However, because intra-abdominal (visceral) fat is the fat with the strongest ties to the metabolic abnormalities of overweight/obesity, it is important to study the effects of weight loss on body fat distribution and on the amount of intra-abdominal fat in particular. Studies have shown that weight loss caused by a low-calorie diet or exercise program can significantly reduce intra-abdominal adiposity. The extent of this reduction depends on initial obesity: generally, the greater the initial amount of excess intra-abdominal fat, the more intra-abdominal fat will be reduced with weight loss. Several studies have reported that moderate weight loss (as little as 5 to 10% of initial body weight) can reduce intra-abdominal fat by 10 to 30%. Moreover, for a given amount of weight loss, exercise burns more intra-abdominal fat than caloric restriction while preserving lean body mass (skeletal muscle). It is therefore possible to reduce intra-abdominal fat without necessarily losing weight. Exercise can reduce intra-abdominal fat while increasing lean body mass, causing no change in body weight.