Lipid and lipoprotein changes after long-term weight reduction: the influence of gender and body fat distribution.

This study was designed: 1) to evaluate the effect of weight loss on body fat distribution, 2) to determine whether indices of body fat distribution can be considered as a prognostic indicator for the ability to lose weight and 3) to evaluate whether a change of body fat distribution is associated with changes in plasma glucose, lipids and lipoproteins in both sexes in order to evaluate a gender difference.

63 obese subjects (41 women and 22 men) were treated on an outpatient basis with an energy-reduced, protein-enriched low calorie diet (3150-4200 kJ/day) for a 6-month period. They were divided in different groups according to gender and body fat distribution using the waist-to-hip circumference ratio.

Body fat topography can be altered by dieting, but not by more than it increases when a person gains weight. Body fat distribution seems to be a significant prognostic indicator for the ability to lose weight in women but not in men. Although body weight and the waist-to-hip circumference decreased significantly, no relationships were found between percent decrease in these parameters and percent changes in plasma glucose, lipids and lipoproteins.

We conclude that an important caloric deficit may lead to a series of metabolic improvements but that gender and the type of fat distribution are important confounding factors in the prediction of metabolic success.