Long-Lasting Improvements in Liver Fat and Metabolism Despite Body Weight Regain After Dietary Weight Loss

Abstract

OBJECTIVEWeight loss reduces abdominal and intrahepatic fat, thereby improving metabolic and cardiovascular risk. Yet, many patients regain weight after successful diet-induced weight loss. Long-term changes in abdominal and liver fat, along with liver test results and insulin resistance, are not known.RESEARCH DESIGN AND METHODSWe analyzed 50 overweight to obese subjects (46 ± 9 years of age; BMI, 32.5 ± 3.3 kg/m2; women, 77%) who had participated in a 6-month hypocaloric diet and were randomized to either reduced carbohydrates or reduced fat content. Before, directly after diet, and at an average of 24 (range, 17–36) months follow-up, we assessed body fat distribution by magnetic resonance imaging and markers of liver function and insulin resistance.RESULTSBody weight decreased with diet but had increased again at follow-up. Subjects also partially regained abdominal subcutaneous and visceral adipose tissue. In contrast, intrahepatic fat decreased with diet and remained reduced at follow-up (7.8 ± 9.8% [baseline], 4.5 ± 5.9% [6 months], and 4.7 ± 5.9% [follow-up]). Similar patterns were observed for markers of liver function, whole-body insulin sensitivity, and hepatic insulin resistance. Changes in intrahepatic fat und intrahepatic function were independent of macronutrient composition during intervention and were most effective in subjects with nonalcoholic fatty liver disease at baseline.CONCLUSIONSA 6-month hypocaloric diet induced improvements in hepatic fat, liver test results, and insulin resistance despite regaining of weight up to 2 years after the active intervention. Body weight and adiposity measurements may underestimate beneficial long-term effects of dietary interventions.

Effects of weight regain following intentional weight loss on glucoregulatory function in overweight and obese adults with pre-diabetes

“…Studies by Haufe [14] and Beavers [16] et al more closely resemble the current analysis, in that authors report on the metabolic effects of weight change following an intentional weight loss intervention. In contrast to findings of the present study, Haufe et al [14] report that initial weight loss-associated improvements in insulin sensitivity persist, despite weight regain in the two years following intervention.…”

Measuring the impact of weight cycling on body composition

“…Most studies in overweight and obese patients could not show an adverse effect of weight cycling on visceral fat accumulation [8] or even found an increased gynoid pattern of fat redistribution after weight regain [7,9 & ]. A preferential regain in subcutaneous fat is also supported by the finding of sustained improvements in liver fat and metabolic risk despite substantial weight regain in obese patients [30]. Others found a lower regain in liver fat when compared with weight regain (þ73% vs. þ90% of baseline values) at a sustained reduction in pericardial fat [8].…”

Weight Loss in Nonalcoholic Fatty Liver Disease Patients in an Ambulatory Care Setting Is Largely Unsuccessful but Correlates with Frequency of Clinic Visits

“…It is also important to emphasize that even modest weight loss can have significant long-lasting effects on improvement in liver steatosis, even if patients later regain weight, and that exercise is a promising intervention for NAFLD even in the absence of weight loss [29]–[31].…”