A Cohort Study of Weight Loss and Gliosis

Exclusion Criteria

• •Poorly controlled hypertension or coronary artery disease, or chronic disease (e.g. cancer, multiple sclerosis, autoimmune disease, rheumatic disease) Blood Pressure \> 160/100 mmHG Heart Rate \> 110 bpm
• •Chronic kidney disease (GFR \<60 mL/min/1.73 m2),
• •Presence of cirrhosis (Nonalcoholic Fatty Liver Disease (NALFD)/Nonalcoholic Steatohepatitis (NASH) are acceptable),
• •Previous or planned (during the study period) obesity treatment with surgery (planned surgery ok for the SWL group) or a weight loss device. However, the following are allowed: (1) liposuction and/or abdominoplasty, if performed \> 1 year before screening, (2) lap banding, if the band has been removed \> 1 year before screening, (3) intragastric balloon, if the balloon has been removed \> 1 year before screening or (4) duodenal-jejunal bypass sleeve, if the sleeve has been removed \> 1 year before screening,
• •A1c \> 8.5% in Bariatric group; A1c ≥ 6.5% for BWL and HWC groups,
• •Current use of insulin (insulin ok for Surgical Weight Loss group, also called SWL), DPP-4 inhibitors, thiazolidinediones or medications known to alter metabolic function (e.g. atypical antipsychotics, corticosteroids),
• •Pregnancy or breastfeeding,
• •MRI contraindications (e.g. implanted metal, claustrophobia), or unable to have MRI or fit in MRI scanner
• •Current smoking/daily use of nicotine containing products (cigarettes, e-cigarettes, vaping or other nicotine containing products) or heavy alcohol use,
• •Weight \>450 pounds (iDXA limit),
• •Weight-reduced from lifetime maximum weight by \>16%,
• •Weight not stable over past 3 months (±10%),
• •T2D (for BWL or HWC),
• •Inability to participate in a weight loss program (BWL)
• •History of eating disorder or current eating disorder, currently enrolled in a weight loss program (ok for the SWL group provided weight stability and lifetime weight-reduced maximum conditions are met) or taking medications to lose weight
• •Severe food allergies
• •Any condition that the study physician determines to be unsafe for participation