Khalafi · Obesity reviews : an official journal of the International Association for the Study of Obesity 2021 · systematic review and meta-analysis · n=2,285 participants (34 studies, 38 intervention arms)

Effect of resistance training with and without caloric restriction on visceral fat: A systemic review and meta-analysis.

Cited 54 times in the scientific literature.

Level 1 - systematic review of randomized trials

Systematic review and meta-analysis of intervention trials

PubMed 33998135 · doi:10.1111/obr.13275 · record verified 2026-08-26

What was done

A systematic review and meta-analysis searched PubMed and Scopus through December 2020 to evaluate the effect of resistance training (RT) with and without caloric restriction (CR) on visceral fat (VF). Standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated across 34 studies comprising 38 intervention arms and 2,285 participants, analyzing RT versus control and RT plus CR versus CR alone separately.

What was found

RT alone significantly reduced VF compared to controls (SMD reported as -0.24, 95% CI -0.34 to -0.13, p < 0.001; I² = 4.17%, p = 0.40; 24 arms). Subgroup analyses showed significant reductions in participants with obesity (p = 0.04) and without obesity (p < 0.001), in medium-term (p = 0.001) and long-term (p = 0.002) interventions, and in middle-aged (p = 0.03) and older adults (p = 0.001), but not in pediatric participants (p = 0.08). In contrast, RT plus CR showed no statistically significant additional effect on VF compared to CR alone (SMD 0.23, 95% CI -0.04 to 0.51, p = 0.09; I² = 58.76%, p = 0.003; 14 arms).

Why it matters

This review establishes that standalone resistance exercise is an effective intervention for decreasing visceral adiposity across adult age and weight categories, though it may not augment visceral fat loss beyond what is achieved by caloric restriction alone.

Limits

The RT plus CR comparison had substantial heterogeneity (I² = 58.76%) and fewer intervention arms (14 vs 24). Visceral fat reductions did not reach significance in pediatric cohorts. Specific measurement modalities for visceral fat (e.g., CT, MRI, DXA), training protocols (intensity, volume, frequency), and dietary adherence were not reported in the abstract.

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