Weight loss reduces intermuscular adipose tissue and liver fat compared to exercise: implications for muscle quality and metabolic health
Authors' conclusion
Weight loss is more effective than endurance exercise training without weight loss for reducing IMAT and liver steatosis, with IMAT loss exceeding muscle loss. Plasma lipids and metabolites signatures are associated with liver fat and IMAT, supporting their potential utility as noninvasive biomarkers.
Study context
- Population
- Adults with obesity
- Participants
- 46 adults
- Comparison
- Weight loss vs endurance exercise training without weight loss vs delayed control
- Primary endpoint
- Reductions in IMAT and hepatic fat (MRI)
- Follow-up
- 12 weeks
Methodological details12-week intervention, delayed-control
- 12-week intervention
- Delayed-control
Primary result
As reported in the abstract
WL: change in liver steatosis (P < .0001)
−33.1%
WL: change in intermuscular adipose tissue (IMAT) volume (P < .0001)
−12.7%
Further findings
Body weight, insulin sensitivity, muscle mass, VO₂peak · 12 weeks
- WL: change in body weight (P < .001)
- −10.5%
- WL: improvement in insulin sensitivity (P = .004)
- 42%
- WL: change in skeletal muscle mass (P = .17); IMAT decreased significantly more than muscle mass
- −4.2%
- EX: increase in insulin sensitivity (P = .04)
- 23%
- EX: increase in VO₂peak (P < .001)
- 7.6%
- DXA overestimated muscle loss compared with MRI
Plasma lipidomics and metabolomics
- WL decreased plasma sphingolipids and diacylglycerols; EX reduced acylcarnitines
- Plasma TG and branched-chain amino acids strongly correlated with liver fat; TG showed strongest association with IMAT volume
Original publication
Weight loss reduces intermuscular adipose tissue and liver fat compared to exercise: implications for muscle quality and metabolic health. J Clin Endocrinol Metab. Published 31 January 2026. doi:10.
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