The TABFAT trial will test whether tirzepatide activates brown fat and induces white fat browning in premenopausal women with obesity.
Evidence
This is a 34-participant randomized placebo-controlled 24-week trial protocol using imaging, infrared thermography, and subcutaneous adipose tissue molecular and histology measures.
Caveat
Because this is a design paper, it reports planned endpoints rather than clinical, metabolic, or thermogenic results.
Simplified
BACKGROUND: Obesity is a complex disease marked by excessive, dysfunctional adipose tissue accumulation. Recent research underscores the pivotal role of (BAT) in metabolic health and its potential as a therapeutic target for obesity management. Emerging preclinical and clinical evidence suggests that second-generation anti-obesity drugs, especially dual agonists such as tirzepatide, may enhance BAT activity. Additionally, beige adipose tissue, derived from (WAT), may contribute significantly to whole-body thermogenesis, yet its role remains underexplored.
METHODS: This investigator-initiated, randomized, placebo-controlled clinical trial aims to evaluate the effects of tirzepatide on BAT activity and in premenopausal women with obesity. Thirty-four participants will be randomized 1:1 to receive either tirzepatide or a placebo for 24 weeks. Primary outcomes include changes in BAT volume and activity, assessed using 18F-FDG-PET/CT, MRI, and infrared thermography, as well as the induction of WAT browning, evaluated through changes in mRNA expression patterns and histomorphometric alterations in subcutaneous adipose tissue samples. Secondary outcomes will involve the assessment of whole-body composition, resting energy expenditure, and various metabolic health markers, correlated with thermogenic adipose tissue changes. Comparative analysis of BAT assessment methods will refine protocols for research and clinical use.
DISCUSSION: This study is the first to systematically explore the potential of pharmacological obesity management to enhance BAT activity and induce WAT browning. Results may establish thermogenic adipose tissue augmentation as a novel mechanism of action for second-generation anti-obesity medications.
TRIAL REGISTRATION: ClinicalTrials.gov NCT06893211. Registered on 2025 March 25.
Key numbers
34
Participants
Total number of participants enrolled in the trial.
24 weeks
Treatment duration
Length of the intervention period for participants.
Full Text
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