Effects of weight loss on regional fat distribution and insulin sensitivity in obesity.

Goodpaster, B H; Kelley, D E; Wing, R R; Meier, A; Thaete, F L

doi:10.2337/diabetes.48.4.839

Cited by 608Diabetes, Cardiovascular Risks, and LipoproteinsAdipokines, Inflammation, and Metabolic DiseasesCardiovascular Disease and Adiposity

Effects of weight loss on regional fat distribution and insulin sensitivity in obesity.

Goodpaster, B H, Kelley, D E, Wing, R R, Meier, A, Thaete, F L·1999·Diabetes

DOI 10.2337/diabetes.48.4.839

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Abstract

Weight loss (WL) decreases regional depots of adipose tissue and improves insulin sensitivity, two parameters that correlate before WL. To examine the potential relation of WL-induced change in regional adiposity to improvement in insulin sensitivity, 32 obese sedentary women and men completed a 4-month WL program and had repeat determinations of body composition (dual-energy X-ray absorptiometry and computed tomography) and insulin sensitivity (euglycemic insulin infusion). There were 15 lean men and women who served as control subjects. VO2max was unaltered with WL (39.2 +/- 0.8 vs. 39.8 +/- 1.1 ml x fat-free mass [FFM](-1) x min(-1)). The WL intervention achieved significant decreases in weight (100.2 +/- 2.6 to 85.5 +/- 2.1 kg), BMI (34.3 +/- 0.6 to 29.3 +/- 0.6 kg/m2), total fat mass (FM) (36.9 +/- 1.5 to 26.1 +/- 1.3 kg), percent body fat (37.7 +/- 1.3 to 31.0 +/- 1.5%), and FFM (59.2 +/- 2.3 to 55.8 +/- 2.0 kg). Abdominal subcutaneous and visceral adipose tissue (SAT and VAT) were reduced (494 +/- 19 to 357 +/- 18 cm2 and 157 +/- 12 to 96 +/- 7 cm2, respectively). Cross-sectional area of low-density muscle (LDM) at the mid-thigh decreased from 67 +/- 5 to 55 +/- 4 cm2 after WL. Insulin sensitivity improved from 5.9 +/- 0.4 to 7.3 +/- 0.5 mg x FFM(-1) x min(-1) with WL. Rates of insulin-stimulated nonoxidative glucose disposal accounted for the majority of this improvement (3.00 +/- 0.3 to 4.3 +/- 0.4 mg x FFM(-1) x min(-1)). Serum leptin, triglycerides, cholesterol, and insulin all decreased after WL (P < 0.01). After WL, insulin sensitivity continued to correlate with generalized and regional adiposity but, with the exception of the percent decrease in VAT, the magnitude of improvement in insulin sensitivity was not predicted by the various changes in body composition. These interventional weight loss data underscore the potential importance of visceral adiposity in relation to insulin resistance and otherwise suggest that above a certain threshold of weight loss, improvement in insulin sensitivity does not bear a linear relationship to the magnitude of weight loss.

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Reduced lean mass with weight loss could result primarily from a reduction in low-density/low-quality muscle compared to normal density muscle.
“In addition, reduced lean mass with weight loss could result primarily from a reduction in low-density/low-quality muscle compared to normal density muscle [80], a finding which could allay concerns.”
From The Role of Lifestyle Modification with Second-Generation Anti-obesity Medications: Comparisons, Questions, and Clinical Opportunities (2023) · cites this paper as [80]

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Authors: Goodpaster, B. H., Kelley, D. E., Wing, R. R., Meier, A., & Thaete, F. L.
Affiliations: University of Pittsburgh (US)
ORCID: Goodpaster, B H
Wing, R R
Venue: Diabetes
Publisher: American Diabetes Association
Published: 1999-04-01
Volume: 48
Issue: 4
Pages: 839-847
ISSN: 0012-1797 (ISSN-L)
1939-327X
DOI: 10.2337/diabetes.48.4.839
OpenAlex: W2046666469
Cited by: 608
References: 0
Citations by year: 2026: 11 · 2025: 10 · 2024: 8 · 2023: 12 · 2022: 9 · 2021: 15 · 2020: 20 · 2019: 15 · 2018: 19 · 2017: 17 · 2016: 18 · 2015: 14 · 2014: 31 · 2013: 21 · 2012: 29
FWCI: 19.43
Type: journal article
Language: en
Open access: closed
Locations: Diabetes (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (5p30dk046204-15)
National Institute of Diabetes and Digestive and Kidney Diseases (R01 DK49200-02, 1P30DK-46204, R01DK049200)
National Center for Research Resources (M01RR000056, 5 M01 RR00056)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
Keywords: weight loss, obesity, insulin sensitivity, regional adiposity, visceral adipose tissue, subcutaneous adipose tissue, body composition, insulin-stimulated glucose disposal, leptin, fat-free mass, VO2max, triglycerides, cholesterol, serum insulin, regional fat distribution, nonoxidative glucose disposal
MeSH terms: Abdomen, Adipose Tissue, Adult, Body Composition, Female, Humans, Insulin Resistance, Male, Obesity, Thigh, Weight Loss, Muscle, Skeletal

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Effects of weight loss on regional fat distribution and insulin sensitivity in obesity.

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