Strength vs. Cardio for Visceral Fat: The 2-Year Test

If your goal is less visceral fat, the evidence does not give strength training or endurance training a winner's trophy. A 24-month randomized trial in adults with obesity found that both reduced visceral fat, while the difference between the two programs was not statistically significant (p=0.13). The more revealing result was practical: only about 30% of participants met the study's definition of good training adherence at 12 months.

That shifts the useful question. Rather than asking whether lifting beats cardio for abdominal fat around the organs, ask which activity you can repeat often enough for long enough to matter. The answer may be barbells, cycling, brisk walking, swimming, or a home routine. The study does not show that every exercise plan produces the same result. It shows that, in this comparison, assigning people to strength or endurance training did not produce a detectable difference in visceral-fat change.

A rare long-term head-to-head test

The STEN trial, published by Stefanie Lehmann and colleagues in 2024, randomized 239 adults with abdominal obesity to strength or endurance training for 24 months. Participants were asked to complete two to three supervised 60-minute sessions each week and received standard nutritional counseling.

These were adults at meaningful metabolic risk: their mean age was 44 years, 74% were women, mean body mass index was 37 kg/m², and mean visceral adipose tissue volume was about 4,050 cm³ at baseline. Researchers used magnetic resonance imaging to quantify abdominal visceral adipose tissue; change in VAT area after 12 months was the primary endpoint, while the report also describes VAT-volume dynamics through 24 months.

Both groups reduced visceral fat over the study period. The comparison between strength and endurance training showed no statistically significant difference at 12 or 24 months (p=0.13). A non-significant result does not prove that the programs are identical, and the abstract does not provide a confidence interval or precise arm-by-arm VAT changes. It does mean this trial did not detect superiority for either modality.

The delivered dose mattered more than the assigned workout

The trial's adherence figures explain why "two years of supervised exercise" should not be mistaken for "two years of exercise completed by everyone." Retention was approximately 50%, and about 30% of participants had good adherence at 12 months. The good-adherence subgroup had a directional trend toward greater VAT reduction, but the published abstract does not report a precise subgroup effect. That supports an intuitive interpretation without allowing a numerical claim about how much more fat adherent participants lost.

The broader evidence points in the same direction. A 2023 systematic review and meta-analysis by Recchia et al. examined randomized trials in adults with overweight or obesity and evaluated exercise dose while controlling for weekly energy deficit. It found that exercise dose drove the magnitude of visceral-fat reduction across modalities. The available report does not support a specific weekly threshold, so claims that everyone needs a particular number of MET-hours or calories burned would outrun the evidence.

A 2025 meta-analysis and meta-regression by Kazeminasab et al. reached a related conclusion for ectopic fat: exercise volume predicted change, and exercise combined with dietary intervention outperformed exercise alone. Ectopic fat includes, but is not limited to, visceral fat, so this is supporting context rather than a direct replication of STEN's endpoint.

STEN offered dietary counseling but did not rigorously monitor or enforce dietary adherence. That leaves an important source of variation. Participants may have changed their eating patterns differently, and those differences could have affected both fat loss and metabolic measures. You cannot cleanly assign every observed benefit to exercise alone.

Why the strength-versus-cardio argument keeps losing

STEN is not an isolated null comparison. A 2025 pairwise and network meta-analysis by Khalafi et al. found statistically equivalent VAT reductions from aerobic and resistance training in people with prediabetes or type 2 diabetes. Its population differs from STEN's general obesity cohort, so its estimates cannot be treated as interchangeable. Still, its modality result matches the long-term MRI trial.

A 12-month randomized trial in adults aged 65 and older with obesity also compared aerobic, resistance, and combined training while participants dieted. The Waters et al. trial offers a useful structural parallel, but its older population and diet co-intervention make it a different test. It cannot settle whether combined training adds to either single modality in younger adults without a structured diet.

Combined training remains an open question, not a free bonus claim. It may suit people who enjoy variety or want both strength and aerobic-fitness adaptations. Whether it consistently produces additional visceral-fat loss beyond an equivalent exercise dose of one modality needs more direct evidence.

Metabolic gains can arrive before dramatic fat loss

STEN reported continuous improvement in insulin-sensitivity measures in both groups, independent of assigned exercise type. Those measures are metabolic outcomes, not proof of fewer heart attacks, longer life, or a specific cellular mechanism. They do matter because visceral-fat volume is only one marker of cardiometabolic health.

A 2025 study by Sharma et al. linked higher aerobic fitness with better adipose-tissue insulin resistance. The relationship was not limited to skeletal-muscle insulin sensitivity and was partly independent of fat-volume changes. This association fits STEN's pattern, but it does not establish that the same mechanism caused the trial's improvements. Exercise can improve metabolic function even when changes on an imaging scan look modest.

Adherence is also a design problem

It would be easy, and wrong, to read STEN's adherence data as a story about insufficient willpower. A supervised gym schedule two or three times weekly for two years asks a lot of people managing work, family, transport, injury, and ordinary life.

In a 2025 randomized trial of postmenopausal women, Tan et al. found measurable adiposity reductions with lower-volume, lower-intensity home-based exercise, with or without a Mediterranean-style diet. The population and intervention differ from STEN, and the result does not establish a minimum effective dose for VAT. It does show why lower-friction delivery models deserve serious attention.

Hormonal status may also help explain why people respond differently. A 2023 meta-analysis in postmenopausal women by Khalafi et al. found that estrogen deficiency attenuated exercise-related visceral-fat reduction. Because STEN enrolled mostly women with a mean age of 44, menopausal variation could have contributed to individual differences. The abstract does not provide sex- or menopause-stratified STEN outcomes, so that explanation remains untested within this trial.

What to do with this evidence

Choose the kind of exercise you will realistically keep doing, then make the plan easy enough to survive a bad week.

Strength training and endurance training both reduced visceral fat in STEN; neither proved superior. Build a routine around preference, access, injuries, skills, and schedule. Add dietary structure if fat reduction is a priority, because meta-analytic evidence finds larger ectopic-fat changes when exercise and diet are combined. Avoid treating carbohydrate restriction as mandatory: a 2025 meta-analysis by Feng et al. found body-composition effects from carbohydrate-restricted diets varied by diet type and what replaced carbohydrate.

The strongest conclusion is narrow and useful. For adults like those in STEN, the evidence does not support a categorical claim that lifting or endurance exercise wins for visceral fat. The better program is the one that delivers enough repeated work over months and years to become part of your life.