Fat distribution and metabolic variables were studied in 8 black and 10 white age- and weight-matched obese women undergoing a 6-mo weight-reducing regimen. Fat patterning was determined by using anthropometry and computed tomography to quantitate total, subcutaneous, and visceral adipose tissue (VAT) areas at the L2-L3 and L4-L5 levels of the lumbar spine, before, during, and after a modified fast. Black women had smaller depots of VAT than white women at both the L2-L3 (P = 0.004) and L4-L5 (P = 0.054) sites. Differences persisted after an average 17.2-kg weight loss. Although waist-hip ratio was similar in both groups, black women had 23% less VAT than white women (P = 0.007). Black women had significantly lower plasma glucose (P = 0.031) and triglycerides (P = 0.006) with significantly higher plasma high-density-lipoprotein concentrations (P < 0.001). Data from this study suggest that racial differences exist in VAT and metabolic risk factors for obesity-related illness.