Visceral adipose tissue plays a key role in the development of Metabolic Syndrome and Atherosclerotic Diseases. Preliminary results from 10 years follow-up of the FLORINASH cohort were obtained on 44 obese non diabetic subjects. 23 patients underwent to lifestyle changes and 21 to Metabolic Bariatric Surgery with 5 years as time since surgery for 7 patients and 10 years for 14 patients. All patients underwent abdominal CT scan by which subcutaneous and visceral adipose tissue volumes were measured between D12 vertebra and femoral heads. Furthermore, the area of skeletal muscle tissue (SMT) and subcutaneous (SAT) and visceral adipose tissue (VAT) was calculated on a slice passing through the L3 vertebral soma. Post-bariatric patients showed a reduction in VAT and SMT amount than patients in the diet arm, while they didn’t show any difference in SAT and total adipose tissue volume. Subdividing patients on the basis of time since surgery, we observed that those operated since 5 years showed a greater reduction in VAT compared to 10 years post-surgery patients (p=0,06), while the last had enhanced sarcopenia. VAT and total AT quantity were significantly correlated with weight, BMI, waist circumference, adiposity evaluation by BIA and DEXA, but not with metabolic parameters. SM area was correlated with hand grip strength, indicative of overall muscle strength of the body (p=0,011). VAT area was not associated with age but significantly correlates with BMI, waist (p<0,001), body weight (p=0,013), adipose tissue (BIA: % Fat p<0,001, kg Fat p<0,001, DEXA: Fat p<0,001). VAT amount positively correlates with the components of metabolic syndrome such as glycemia (p=0.007), insulinemia (p=0.001), triglycerides (p=0.039), HBA1c (p<0.001), insulin resistance (HOMA p=0.002), intima-media thickness (p=0.007) and degree of hepatic steatosis (p<0.001). The exactly measure VAT by CT scan slice might contribute to really understand and predict the cardiometabolic risk of overweight or obese patients and could be performed routinely in high and very high cardiovascular risk patients.