Effect of high-power radiofrequency combined with a hypocaloric diet on abdominal subcutaneous and visceral fat: a preliminary randomized pilot study

Abstract Visceral and subcutaneous abdominal fat are associated with metabolic and cardiovascular risk. This preliminary randomized pilot study evaluated a high-power radiofrequency energy-based device (EBD) treatment, alone or combined with a hypocaloric dietary intervention, for visceral and subcutaneous abdominal fat reduction. Twenty middle-aged participants were randomly allocated to one of two parallel groups: EBD combined with dietary intervention (7 males, 3 females; mean age 58.2 ± 8.89 years) and EBD alone (5 males, 5 females; mean age 54.4 ± 12.5 years). Both groups received 12 EBD sessions over 6 weeks using a four-channel high-power radiofrequency device. Anthropometric, biochemical, and volumetric abdominal fat measurements were assessed at baseline and post-treatment, with visceral fat additionally evaluated at the 3-month follow-up. Both groups demonstrated reductions in abdominal fat volume. The EBD + diet group showed greater reductions in visceral fat (15.0%) and subcutaneous fat (18.6%) than the EBD-only group, which showed reductions of approximately 9.1% and 9.2%, respectively. Between-group change-score analyses favored the EBD + Diet group for weight and BMI, while differences in visceral and subcutaneous fat did not reach statistical significance. Most biochemical variables showed no clear between-group differences, although exploratory between-group differences were observed for triglycerides, insulin, and HOMA-IR. At the 3-month follow-up, mean visceral fat remained below baseline in both groups. Reductions in visceral and subcutaneous abdominal fat were observed in both treated groups. These findings should be interpreted cautiously due to the exploratory design and small sample size. Larger studies are required to confirm efficacy and long-term outcomes.