Background: Obesity is a major health problem that has become a global epidemic.
Overweight and obesity are commonly associated with the development of several
pathologies, such as insulin resistance, cardiovascular diseases, sleep apnea and several types
of cancer, which can lead to further morbidity and mortality. An increased abdominal adiposity
renders overweight and obese individuals more prone to metabolic and cardiovascular
Objective: This Review aims to describe the dietary strategies to deal with excess adiposity
given the medical, social and economic consequences of obesity.
Methods: One hundred and eighty-five papers were included in the present Review.
Results: Excess adiposity leads to several changes in the biology, morphology and function
of the adipose tissue, such as adipocyte hypertrophy and hyperplasia, adipose tissue inflammation
and fibrosis and an impaired secretion of adipokines, contributing to the onset of obesity-
related comorbidities. The first approach for obesity management and prevention is the
implementation of a diet combined with physical activity. The present review summarizes the
compelling evidence showing body composition changes, impact on cardiometabolism and
potential adverse effects of very-low calorie, low- and high-carbohydrate, high-protein or
low-fat diets. The use of macronutrients during the preprandial and postprandial state has
been also reviewed to better understand the metabolic changes induced by different dietary
Conclusion: Dietary changes should be individualised, tailored to food preferences and allow
for flexible approaches to reducing calorie intake in order to increase the motivation and
compliance of overweight and obese patients.