Objective: To evaluate the effectiveness of the fast weight loss method on liver steatosis, fibrosis, inflammation, glycemic and lipids features and body composition in patients with severe Nonalcoholic Steatohepatitis (NASH) and Type 2 Diabetes (T2D). Methods: A 24-week open prospective randomised controlled clinical trial including 80 adult patients (aged 40-65 years) was performed. The patients after randomisation were divided in two groups: Main group followed the fast weight loss method; Control group received conventional drug treatment. The fast weight loss method included calorie restriction, salt intake, walking and sexual self-restraint. The conventional drug therapy included Vitamin E, Orlistat, Pioglitazone hydrochloride, Atorvastatin, Lisinopril, benzodiazepines and anti-inflammatory agents. Primary endpoints: ultrasound and histology suggestive of steatohepatitis, hepatic enzymes, weight loss, 2-hour oral glucose tolerance test, HbA1c. Secondary endpoints: blood pressure, lipids. Results: 83% patients completed the study. In Main weight lost 7-16 kg (10-20% from baseline) for 8-10 weeks. In Main weight lost due to reduction of fat mass only. Main vs. Controls showed higher decrease in fat mass from baseline (P < 0.001). Ultrasound imaging and liver histological scoring system evidenced significant improvement on liver steatosis/fibrosis in Main (P < 0.001). In Main vs. Controls weight lost at 24 weeks led to positive laboratory changes in ALT, AST, 2-hour OGTT, HbA1c, HOMA-IR, BP, cholesterol, triglycerides, bilirubin total, blood hemoglobin (P = 0.01). The fast weight loss in the patients adequately led to decrease in symptomatic drugs up to complete abolition. Conclusions: The study showed benefits of the fast weight loss method improving in steatosis/fibrosis, biochemical/metabolic outcomes in patients with severe NASH and T2D.

Background: The hypothesis that metabolic rate is inversely correlated with lifespan has long been debating. Another area of controversy is the relationship between metabolic rate (MR) and time-flow perception (TFP), and aging. Aim: to study the impact of overweight and food intake on MR, TFP, chronic disease, aging, lifespan; difficulty in weight loss.Methods. Design: a systematic review. Settings: Web of Science, Scopus, Science Direct, Kopernio, PubMed, Mendeley were searched for articles published from January 1979 until February 2022. The study bases on a viewpoint supported by a systematic literature review of 3612 articles published worldwide.Results: In total, 107 full-text articles were assessed for eligibility. From them, 22 articles were excluded with reasons. Overweight and overeating accelerate MR, leading to hyper-metabolic mode of the body. MR and lifespan are inversely correlated. TFP depends on MR; accelerated MR leads to deceleration of TFP. Every person has an individual ability to gain weight up to 'maximum bodyweight', which indicates the individual potential energy to weight gain. Overweight excessively consumes the body ‘vital energy’, devours body potential energy. Weightloss creates ‘body power to weight gain’ that increases physical/mental activity, recovers from disease, or weight regain. The body should less calorie intake due to decrease in MR by age. Very-low-calorie diets should use for weight loss.Conclusions: Our findings support that overweight and overeating increase MR, which delays time-flow perception, accelerates aging, limits lifespan. Metabolic intoxication should be managed during weight loss.

Background: The impact of overweight and adipocyte size on the development of type 2 diabetes mellitus (T2DM) even remains unclear. Aim: To study: 1) the relationship between the state of adipocytes and/or overweight/obesity, the development of T2DM and its clinical and laboratory signs; 2) the effect of weight loss on glycemic level, hyperinsulinemia (HI), insulin resistance (IR), and T2DM status. Methods. Design: a systematic review. Settings: Web of Science, EBSCO, Scopus/ Science-Direct, Google Scholar, PubMed, Cochrane, и Wolter Kluwer were searched for articles published for 26 years (2000-2026). The study bases on a systematic review of 3853 articles published worldwide. Results. In total, 142 full-text articles were assessed for eligibility. With an increase in overweight, the size of adipose tissue increases, adipocytes increase, the cell radius increase. All it leads to an overload of intracellular transport and internal organs. Increase in cell size triggers intracellular mechanisms to limit further nutrient supply. When cell size increases excessively, conformational changes in cellular receptors are activated, resulting in the development of IR. The increase in cell size and the maximum accumulation of overweight, as parallel processes, lead to hyperglycemia and HI with gradual development of IR and T2DM. Any type of i ntentional weight loss leads to a decrease in IR, HI and the disappearance of T2DM. Targeted weight loss in patients with T2DM improves metabolic and cardiovascular health, reduces blood pressure and blood sugar, reduces doctor visits, normalization of HbA1c, HI, IR. Conclusions. IR is a protective reaction of the cells, preventing its oversaturation and overflow. Overweight is an independent risk factor for the development of T2DM and its clinical and laboratory manifestations. Targeted weight loss leads to disappearance of symptoms of HI, IR and T2DM.

Background: The impact of overweight and adipocyte size on the development of type 2 diabetes mellitus (T2DM) remains unclear. Aim: We studied (1) the relationship between the state of adipocytes and/or overweight/obesity, the development of T2DM and its clinical and laboratory features; and (2) weight loss effect on glycemic level, endogenous hyperinsulinism (HI), insulin resistance (IR), and T2DM. Methods: We designed a systematic review by searching Web of Science, EBSCO, Scopus/ Science-Direct, Google Scholar, PubMed, Cochrane, and Wolter Kluwer for articles published in 26 years (2000–2026). The study was based on a systematic review of 3853 articles published worldwide. Results: In total, 142 full-text articles were assessed for eligibility. As overweight increases, the size of adipose tissue, adipocytes, and cell radius increase. The increase in cell size overloads intracellular transport and internal organs. The development of IR is a conformational change in cellular receptors caused by an excessive increase in cell size. The increase in cell size with overweight gradually leads to hyperglycemia and HI with the development of IR and T2DM. Any targeted intentional weight loss in patients with T2DM improves metabolic and cardiovascular health, reduces blood pressure and blood sugar, and decreases HI, IR, and T2DM. Conclusions: IR is a protective response of cells that prevents oversaturation and overflow. Overweight is an independent risk factor for the development of HI, IR, and T2DM. Targeted weight loss leads to the cure of HI, IR and T2DM.