Impact of an MRI Body Fat Imaging Report on Obesity-Related Cardiometabolic Risk: Findings From the BODY-REAL Study,...

Advanced imaging can inform risk assessment and preventive/therapeutic decision-making to enhance care. It is not known how quantification of body fat distribution using advanced imaging and communication of the result through a graphic report may impact cardiometabolic risk factors and attitudes/behaviors among persons living with overweight or obesity. The BODY-REAL study assessed whether providing patients with (1) visual body fat MRI reports compared with the weight/body mass index (BMI) alone and (2) direct-to-patient reports versus through providers would improve cardiometabolic risk among individuals at elevated cardiometabolic risk.

Participants were randomized in a 2 × 2 factorial design to receive a BMI or MRI body fat distribution report, provided direct-to-patient report or a report through their healthcare provider. Clinical and psychosocial outcomes were measured at 2 weeks, 3, and 6 months and compared using analysis of covariance and linear models with both fixed and random (time-updated) effects.

29 participants (31% female, mean BMI 33.6 kg/m²) were randomized. After 6 months of follow-up, MRI report recipients had lower fasting glucose and higher physical activity scores (p < 0.01). Provider-mediated reporting demonstrated greater medication adherence (p = 0.01) and greater perception of personal control of diabetes (p = 0.02) but lower perception of diabetes-related risk (p = 0.003). There were no significant differences in BMI, blood pressure, cholesterol, glycosylated hemoglobin, or other risk perception across study arms.

This pilot feasibility study demonstrated potential for direct-to-patient visualization of body fat distribution to improve risk markers and preventive behaviors. Further investigation in a sufficiently powered study is warranted.

ClinicalTrials.gov NCT04763772.