Objective: To assess the effects of a moderately hypoenergetic Mediterranean diet (MHMD) and exercise program on body cell mass (BCM) and cardiovascular disease risk factors in obese women. Subjects/Methods: Forty-seven obese women, 39.7713.2 years of age, with a body mass index (BMI) ¼ 30.776.0 kg/m 2 , completed the study. The following were measured at baseline, 2 and 4 months: BCM, BCM index (BCMI), body weight, BMI, fat-free mass (FFM), fat mass (FM), total body water (TBW), extracellular water (ECW) and intracellular water (ICW) using bioelectrical impedance analysis; fasting blood glucose (FBG), serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) concentrations; systolic (SBP) and diastolic (DBP) blood pressure. Results: Body weight, BMI, FM, TC and TG significantly decreased (Po0.001; Po0.002 (TG)) at 2 and 4 months. FFM, TBW, ECW, FBG and DBP significantly decreased at 2 months (Po0.05 (FFM); Po0.001). LDL-C significantly decreased (Po0.001), while HDL-C significantly increased (Po0.002) at 4 months. BCM, BCMI, ICW and SBP remained stable over time. Conclusion: BCM was preserved and cardiovascular disease risk factors improved in obese women placed on a MHMD and exercise program for 4 months.