For many people trying to lose weight, one of the biggest frustrations is seeing the weight return after months or years of hard work.
Many people assume that once the weight comes back, all of the health benefits disappear as well.
However, a new long-term study suggests that this may not always be true. Researchers have found that losing a specific type of fat deep inside the abdomen may provide lasting health benefits, even if body weight eventually returns to its original level.
The study was conducted by scientists from Ben-Gurion University of the Negev and international collaborators.
Their findings were published in the journal Circulation. The research focused on visceral fat, a type of fat stored deep inside the abdomen around internal organs such as the liver, intestines, and pancreas.
Unlike the fat that sits just under the skin, visceral fat is considered particularly dangerous. Scientists have linked it to insulin resistance, type 2 diabetes, heart disease, high blood pressure, and other metabolic disorders. Because it surrounds important organs, it can release substances that affect how the body handles sugar, cholesterol, and inflammation.
For many years, doctors have mainly used body weight and body mass index, or BMI, to evaluate health risks. However, researchers increasingly believe that where fat is stored may be more important than total body weight alone. Two people can weigh the same amount but have very different levels of harmful visceral fat.
To investigate this issue, researchers followed 366 participants who had previously taken part in two dietary intervention studies called CENTRAL and DIRECT-PLUS.
These original studies lasted 18 months and examined different healthy eating patterns, including low-fat diets, Mediterranean diets, low-carbohydrate diets, and a special polyphenol-rich green Mediterranean diet combined with physical activity.
What makes the new study unique is its extremely long follow-up period. Researchers continued tracking participants for up to ten years after the original interventions ended. Remarkably, they maintained a retention rate of 96 percent, which is exceptionally high for such a long-term study.
The scientists used advanced MRI scans to measure different types of fat throughout the body. This allowed them to examine visceral fat, liver fat, pancreatic fat, and several layers of abdominal fat in great detail. Unlike simple weight measurements, MRI scans can show exactly where fat is stored.
By the end of the follow-up period, participants had regained most of the weight they originally lost. On average, body weight had returned to baseline levels. At first glance, this might appear disappointing. However, the researchers discovered something unexpected.
Although overall weight returned, several important abdominal fat deposits remained lower than they had been before the intervention. Most importantly, reductions in visceral fat were partially preserved years later. This suggests that the body may retain some of the benefits of earlier healthy lifestyle changes.
The findings became even more interesting when researchers examined disease risk. They found that every 10 percent reduction in visceral fat achieved during the original intervention was linked to a 30 percent lower risk of developing type 2 diabetes during long-term follow-up.
The relationship was remarkably consistent. A 5 percent reduction in visceral fat was associated with a 17 percent lower diabetes risk. A 15 percent reduction was linked to a 40 percent lower risk, while a 20 percent reduction was associated with a 50 percent lower risk.
Importantly, these benefits remained even after researchers accounted for changes in body weight, diet, physical activity, and other health factors. This suggests that visceral fat reduction itself may play a unique role in protecting long-term health.
Professor Iris Shai, the study’s principal investigator, described the findings as evidence of a “cardiometabolic memory.” In other words, the body may remember previous reductions in harmful visceral fat even after weight is regained.
The study also showed that reductions in visceral fat were associated with better insulin sensitivity, lower metabolic syndrome severity, and improved overall cardiometabolic health years later.
Interestingly, other types of fat did not show the same relationship. Liver fat returned to baseline levels, while pancreatic fat actually increased above baseline during follow-up. Although changes in these fat stores were associated with some metabolic measures, they did not consistently predict future diabetes risk the way visceral fat did.
The research has several major strengths. It followed participants for an unusually long period, used highly accurate MRI measurements, and maintained excellent participant retention. These factors make the findings particularly valuable.
However, there are also limitations. The study cannot prove that reducing visceral fat directly causes lower diabetes risk. It shows a strong association, but other factors may also contribute. In addition, participants were involved in structured lifestyle programs, so results may differ in other populations.
Overall, the findings challenge the common belief that weight regain means failure. The study suggests that periods of healthy living may leave behind lasting benefits, especially when they reduce harmful visceral fat. Future research may help doctors focus less on body weight alone and more on reducing the dangerous fat hidden deep inside the abdomen.
Review and analysis: This study provides some of the strongest evidence yet that visceral fat is more important than overall body weight when predicting long-term metabolic health. The use of MRI imaging and ten years of follow-up strengthens the reliability of the findings.
While more studies are needed, the research suggests that successful lifestyle changes may continue benefiting health long after a diet ends. The results support a growing shift in medicine toward measuring body composition rather than focusing solely on weight.
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