Obesity is associated with metabolic complications including insulin resistance, fatty liver disease, dyslipidaemia, and systemic inflammation. Weight loss can improve these complications, yet individuals vary widely in weight loss, fat distribution and metabolic response. Subcutaneous adipose tissue dysfunction, including impaired mitochondrial biogenesis and increased inflammation, is thought to play a central role.
This prospective observational study follows adults with obesity undergoing standard-of-care diet and lifestyle treatment at Helsinki University Central Hospital, Helsinki, Finland. The intervention consists of a very-low-calorie diet for approximately 10 weeks, followed by gradual transition to a conventional weight loss diet and multidisciplinary clinical follow-up.
Assessments are performed at baseline, 6 months, and 12 months and include anthropometry, body composition (BIA, DXA), fasting blood samples, and oral glucose tolerance testing. Subcutaneous adipose tissue biopsies are obtained from four anatomical depots (gluteal, abdominal, breast, and upper arm) for molecular, mitochondrial, epigenetic, and histological analyses.
The primary outcome is diet-induced weight loss over 12 months. Secondary outcomes include changes in fat distribution, insulin sensitivity, lipid profile, inflammation, mitochondrial measures in adipose tissue, and depot-specific adipose tissue characteristics.
