BACKGROUND: To investigate the effects of increased weight-loading on body weight, body composition, fat mass distribution, physical activity and energy balance in individuals with obesity. METHODS: This single-centre non-blinded randomised controlled trial was conducted from August 1, 2021, through February 28, 2022. Adults with obesity class 1 (body mass index, BMI 30 to 35 kg/m2) were assigned to wear either a heavy (high load; 11% of body weight, n = 28) or light (low load; 1% of body weight, n = 30) weight vest for 8 h per day over 5 weeks. RESULTS: High-load treatment reduced fat mass (mean difference -2.60%; 95% CI -3.79 to -1.41) and increased lean mass (mean difference 1.40%; 95% CI 0.37 to 2.42), with no significant effect on body weight. Fat mass reductions were primarily observed in weight-loaded regions but not in the non-weight-bearing regions such as the arms. Waist circumference decreased (mean difference -2.26%; 95% CI -3.81 to -0.71) in the high-load group compared to the low-load group. Despite these beneficial changes, sedentary time was higher in the high-load group (mean difference 4.69%; 95% CI 0.98 to 8.39) compared to the low-load group, while energy expenditure and energy intake remained unchanged. CONCLUSIONS: Increased weight-loading reduced fat mass and increased lean mass, resulting in a healthier body composition. These effects were achieved despite no increase in physical activity. The fat mass-reducing effect was primarily seen in weight-loaded regions, implying local adaptation to the increased loading. TRIAL REGISTRATION: Registered at ClinicalTrials.gov (NCT04697238) in 2021.

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