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You look into the mirror and sigh. You step onto the scale and feel disappointed. You have gained weight. Your belly protrudes more than it once did, and your love handles have become more prominent.
I must lose weight, you think to yourself.
But then again, you've lost weight before--quite a lot of it, in fact--only to gain it all back.
So what's the point? you ask yourself.
What if the reflection you see isn't the whole story? What if losing weight can have lasting health benefits even if the weight eventually regained?
A study recently published in Circulation explores exactly these questions.
But first, consider an important fact about body fat that many people don't know. The fat you can see--the bulging abdomen or the soft tissue around your waist--is only part of the picture. From a medical perspective, the more dangerous fat is often hidden from view. This visceral fat lies deep inside the abdomen, surrounding organs such as the liver, pancreas, and intestines. Visceral fat is biologically active. It releases hormones and inflammatory substances that increase the risk of diabetes, heart disease, fatty liver disease, and many other chronic illnesses.
This new study suggests that what happens to this hidden fat may matter far more than what the bathroom scale says.
The study was published in Circulation on June 2, 2026, by Dr. Hila Klein and colleagues, led by Professor Iris Shai at Ben-Gurion University of the Negev in Israel, together with collaborators from Germany, Harvard University, and Tulane University.
The investigators revisited participants from two earlier lifestyle studies. Years earlier, these volunteers had spent 18 months following healthy diets combined with regular physical activity. Some followed a Mediterranean diet, while others followed a low-carbohydrate or "green" Mediterranean diet enriched with plant polyphenols found in walnuts, green tea, and Mankai--a tiny aquatic plant, also known as duckweed, served daily as a green shake.
What made these studies unique was that the participants didn't just step on a scale. They also underwent MRI scans, allowing researchers to determine exactly where fat was stored in the body. The scans distinguished between visceral fat surrounding the internal organs, subcutaneous fat lying just beneath the skin, and fat stored inside the liver and pancreas.
Five to ten years later, the researchers invited the participants back. They measured their weight again, repeated the MRI scans, performed blood tests, and determined who had developed diabetes or other metabolic problems. In total, more than 300 participants were followed for up to a decade.
The first result wasn't surprising. Most participants had regained much--or even all--of the weight they had lost during the original study.
The second finding, however, surprised the researchers. Despite regaining weight, many participants still carried less visceral fat than they had before beginning the lifestyle program. Their waist measurements also remained smaller, on average, even though the number on the scale had returned to nearly its original value.
Even more importantly, people who had lost the greatest amount of visceral fat during the original intervention continued to enjoy better metabolic health years later. They were more likely to have better insulin sensitivity--meaning their bodies responded more effectively to insulin--a healthier metabolic profile, less severe metabolic syndrome, and a lower risk of developing type 2 diabetes.
One of the most striking findings was this: for every 10 percent reduction in visceral fat during the original lifestyle program, the long-term risk of developing type 2 diabetes was about 28 percent lower, even after accounting for later weight regain and many other factors.
What new information does this study provide?
For decades, weight-loss research has focused primarily on one number: body weight. This study suggests that the number on the scale doesn't tell the entire story. Where fat is lost may be just as important as how much weight is lost.
The researchers propose that reducing visceral fat may create a lasting metabolic legacy. In other words, the body may retain some of the health benefits gained from losing harmful abdominal fat, even if some--or even all--of the lost weight eventually regained.
This study offers a hopeful message. Weight regain does not necessarily erase every benefit of losing weight. If, during the process, you reduce the dangerous fat surrounding your internal organs, your body may continue to benefit for years afterward. The scale may return to its old number, but your metabolism may not.
That is a victory your bathroom mirror won't always show.
EDITOR’S NOTE: Shahar Madjar, MD, MBA, is a urologist and an author. He practices at Schoolcraft Memorial Hospital in Manistique, and in Baraga County Memorial Hospital in L’Anse. Find his books on Amazon or contact him at smadjar@yahoo.com.