Visceral fat is different from regular fat because it actively harms metabolism, and tesamorelin reduces it in a way that improves long-term metabolic health by affecting fat quality, muscle, and mitochondria.

Tesamorelin independently increases fat density in visceral and subcutaneous adipose tissue, indicating improved fat quality with smaller adipocytes, better vascularization, reduced hypoxia, and decreased inflammation, independent of fat quantity changes.

Tesamorelin has robust human evidence demonstrating specific reductions in metabolically harmful fat depots including visceral, liver, and intramuscular fat.

In a 6-month randomized, placebo-controlled trial, tesamorelin significantly reduced both visceral and hepatic (liver) fat, with liver fat reduction being particularly important as it improves insulin sensitivity and glucose metabolism.

Tesamorelin upregulates genes involved in oxidative phosphorylation across the electron transport chain and in fatty acid oxidation, leading to cellular-level metabolic remodeling that enhances fat burning efficiency at the mitochondrial level.

A hormone treatment called tesamorelin decreases belly fat by 42 square centimeters more than a placebo in people with HIV who have excess abdominal fat after six months of treatment.