Obesity-related Metabolic Damage Can Be Reversed by Dietary Composition
The macronutrient content of the diet influences the cardiometabolic benefits of weight loss. Image credit: Petersen others., doi: 10.1016/j.cmet.2026.07.020.
“Obesity can lead to metabolic diseases such as atherosclerotic dyslipidemia, prediabetes, and fatty liver disease, which are risk factors for type 2 diabetes and cardiovascular disease,” explained Dr. Samuel Klein from Washington University School of Medicine in St. Louis.
“Insulin-resistant glucose metabolism in skeletal muscle and liver is a key factor in obesity-related metabolic diseases.”
“While weight loss through energy intake reduction is essential for treating metabolically unhealthy obese individuals, the macronutrient composition of the diet also plays a crucial role in improving metabolic health.”
Results from a new randomized clinical trial published in Cell Metabolism showed that different diets have varying effects on metabolic health beyond weight loss alone.
In the study, 55 adults with obesity, prediabetes, and fatty liver disease were assigned to either a very low-carbohydrate ketogenic diet, a Mediterranean diet, or a very low-fat plant-forward diet, with all meals provided to ensure adherence.
Each group experienced an approximately 10% body weight loss over five months, with all three diets improving muscle insulin sensitivity. However, the ketogenic diet showed significantly greater benefits for liver health.
Participants on the keto diet demonstrated substantial improvements in hepatic insulin sensitivity, liver fat reduction, and other metabolic markers compared to the other diets.
These findings suggest that dietary composition, in addition to calorie restriction, plays a crucial role in reversing obesity-related metabolic diseases.
The study authors caution that more research is needed to determine the specific effects of carbohydrate reduction in the absence of full ketosis.
“Our data indicate that reducing carbohydrate intake may have significant therapeutic effects on metabolism beyond weight loss,” said Dr. Klein.
“The ketogenic diet group did not experience adverse effects on blood fat or cholesterol despite consuming a high-fat diet, which was unexpected and promising,” added Dr. Max Petersen from the University of Washington School of Medicine.
Overall, the study highlights the importance of dietary composition in treating metabolic diseases associated with obesity.
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Max C. Petersen others. Effect of dietary macronutrient content on the cardiometabolic response to weight loss: A randomized clinical trial. Cell Metabolism published online on August 27, 2026. doi: 10.1016/j.cmet.2026.07.020
Source: www.sci.news
