**The Study Design:** - Randomized controlled trial with pa…

**The Study Design:**
- Randomized controlled trial with participants wearing weighted vests (~6 kg for 6.6 hours daily) for 6 months vs control group
- Both groups were on very low-calorie diets (1,100-1,300 calories) during the 6-month intervention
- Then followed for an additional 18 months with no intervention (free living)