Callaghan BC, Reynolds EL, Banerjee M, et al. - A dietary weight loss intervention was implemented in severely obese persons which led to improvements in all metabolic parameters except blood pressure, and both intraepidermal nerve fiber density (IENFD) outcomes (at the distal leg and proximal thigh) continued to be stable after 2 years in these people. Given that natural history studies show reductions in IENFD over time, dietary weight loss could cease this progression, however, randomized controlled trials are required.

• Individuals participating in a medical weight-management program were prospectively analyzed; weight loss was ensured with meal replacement of 800 kcal/d for 12 weeks and then transitioning to 1,200 to 1,500 kcal/d.

• At baseline, there were 131 participants, of which 72 (mean [SD] age: 50.1 [10.5] years, 51.4% female) completed 2 years of follow-up.

• Weight loss of 12.4 (11.8) kg was achieved, and improvement in all metabolic syndrome components was evident with the exception of blood pressure.

• No significant change was observed in the IENFD in the distal leg (0.4 [3.3], p = 0.29) and proximal thigh (0.3 [6.3], p = 0.74).

• The Michigan Neuropathy Screening Instrument questionnaire, two Quality of Life in Neurological Disorders subdomains, and quantitative sensory testing cold threshold, all showed improvements.