Patient description: The patient is a 32-year-old obese woman who came to the clinic with weight concerns. She is 165 cm tall and her weight is 113 kg. She is complaining of sleep apnea, PCO and dissatisfaction with her body shape. She is a high-school teacher married for 5 years. She doesn't use any contraceptive methods for the past 4 months and she had no prior pregnancies. She doesn't smoke or use any drugs. She likes to try diets and exercise to lose weight. She completed the four square step test in 14 seconds. Her BP: 130/80, HR: 195/min and her BMI is: 41.54. Her labs: FBS: 98 mg/dl TG: 150 mg/dl Cholesterol: 180 mg/dl LDL: 90 mg/dl HDL: 35 mg/dl Her cardiac assessment is normal. Her joints and ROM are within normal.

Clinical trial eligibility criteria: eligible ages (years): 18.0-39.0,  BMI/Body Composition Are between the ages of 18 (or 17 for military personnel) and 39 (i.e., consistent with the age range of 95% of Active Duty enlisted and 75% of Active Duty officers) Have a Body Mass Index (BMI) in the range of 18.5 to <25 kg/m2 and have a percent body fat by circumference measurements that meets the Army's max allowable body fat standards for individuals classified as "without obesity"; or have a BMI ≥ 30 kg/m2 and have a percent body fat by circumference measurements that exceeds the Army's max allowable body fat standards for individuals classified as "with obesity" (40) Have been weight stable (+/ lbs.) for the past two months (not including temporary body weight fluctuations due to menstrual cycle) and agree not to attempt to lose or gain weight for the duration of the study Participate in 120-300 mins of aerobic exercise over the course of at least 3 days per week as indicated by self-report data and confirmed during the study via actigraphy (i.e., consistent with the self-reported exercise habits of a majority of active duty military personnel) (1, 41) Are willing to participate in all study procedures and comply with all study instruction Females must have normal menstrual cycles between 26-32 days in duration; 5 menstrual cycles within the past 6 months; or able to provide documentation of oral/hormonal contraceptive use which contains low-dose estrogen/progesterone to maintain continuous levels throughout the 28-day cycle (i.e., no placebos) Pass a general medical clearance  have a tattoo on both forearms that obscures the forearms and doesn't allow space for the suction blister induction experienced more than a ~5 lbs. weight gain or loss in the last month than is not transient (e.g., menstrual) participate in more than 300 minutes of aerobic exercise per week as indicated by self-report data and confirmed during the study via actigraphy (i.e., consistent with self-reported exercise habits of ~20% of active duty military personnel) (1, 41) are habitually taking nonsteroidal anti-inflammatory drugs (e.g., Advil), aspirin, lipid-lowering drugs, corticosteroids or immunosuppressants (e.g. Humira) are immune-compromised (e.g., chemotherapy or radiation treatment) are suffering from an autoimmune disease (e.g., lupus) recovering from a surgery within the past 6 months Current doctor-diagnosed and/or treated diabetes, hypertension or dyslipidemia are suffering from sleep apnea smoke, dip, chew or vape tobacco or nicotine-containing products