Browse the evidence

Primary prevention of obesity through population-level public health measures is more cost-effective and yields better results than treating established obesity.

Healthcare systems should prioritize policies that promote healthy eating and physical activity for the entire population, such as regulating advertising of unhealthy foods and building accessible recreational spaces. For individuals, focusing on maintaining a healthy weight from a young age is more effective and less costly than trying to treat obesity later in life.

For older adults (≥65 years) with obesity, weight reduction is recommended only after careful consideration of risks/benefits and patient priorities, whereas overweight older adults should maintain stable body weight to avoid sarcopenia and functional decline.

If you are over 65 and obese, focus on a small calorie cut (500 kcal less than usual) combined with strength training and high protein intake (1-1.5g per kg of body weight). If you are merely overweight, do not try to lose weight; focus on maintaining your current weight and muscle mass to prevent frailty.

Patients with baseline musculoskeletal pain (cervicalgia, knee pain) experience significantly greater lean body mass loss during GLP-1 therapy, suggesting mobility limitations exacerbate muscle catabolism.

If you have joint pain, you are at higher risk for losing muscle while losing weight on GLP-1s. This is because pain limits your movement. Try to maintain some level of gentle activity or resistance training that does not aggravate your pain to protect your muscle mass.

Initiating Type 2 Diabetes screening at age 30 is recommended for asymptomatic individuals in the UAE, which is earlier than the standard age of 35, to address the region's high prevalence of prediabetes and diabetes.

If you live in the UAE and are 30 or older, get your blood sugar checked even if you feel healthy. This is not optional; it is the standard of care because diabetes is common and often silent. Early detection lets you fix it before it damages your heart or kidneys.

Individuals with Type 2 Diabetes should undergo annual screening for Cardio-Renal-Metabolic (CRM) risk, including blood pressure, lipid profile, and kidney function, to identify and manage multi-organ dysfunction early.

Once you have diabetes, you need a full health check-up every year, not just a blood sugar test. This includes checking your blood pressure, cholesterol, and kidney function. This annual check is your best defense against heart disease and kidney failure.

Individuals with Type 2 Diabetes should be screened for Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) using the FIB-4 index, as nearly 70% of T2D patients are affected.

If you have diabetes, ask your doctor to check your liver health using a simple calculation called FIB-4. This test uses your age and blood results to estimate liver scarring risk. Since 70% of people with diabetes have some degree of liver fat, this check is essential for your overall health.

Current clinical guidelines recommend individualized perioperative management for GLP-1 RA users, with recent consensus shifting from mandatory discontinuation to risk-based assessment based on gastrointestinal symptoms and treatment duration.

Do not stop your GLP-1 medication on your own before surgery. Recent guidelines say you should likely keep taking it unless you have severe nausea or vomiting. Your surgical team will create a specific plan for you, possibly adjusting your fasting rules, to keep your blood sugar stable while minimizing lung risks.

Objective measures of physical activity (via accelerometers) in long-term lifestyle intervention trials often show no significant difference between intensive and control groups, despite self-reported improvements and weight loss benefits.

Self-reported exercise improvements may not always reflect objective changes in daily movement. However, even modest objective increases in activity, if sustained, can contribute to cardiovascular benefits, suggesting that any increase in movement is valuable even if it doesn't meet high-intensity targets.

An intensive lifestyle intervention (ILI) focused on weight loss and physical activity reduces total healthcare costs compared to diabetes support and education (DSE), but this cost reduction is largely mediated by the slowing of frailty index progression.

For those managing type 2 diabetes and obesity, an intensive lifestyle program involving significant weight loss and exercise can reduce healthcare costs by about $460 annually. However, this saving is primarily because the program slows down biological aging (frailty). If you are considering such an intervention, focus on the health benefits of slowing frailty; the cost savings are a secondary benefit that may not be statistically significant for every individual.

Increased social support for healthy eating from family mediates the association between intervention attendance and increased fruit and vegetable intake, accounting for 62% of the effect.

If you are trying to eat more fruits and vegetables, involve your family or community in your journey. The study shows that encouragement from family members is a powerful driver of success, mediating over 60% of the improvement in healthy eating. Seek out groups or family members who can support your dietary goals rather than trying to do it entirely alone.

Increases in psychological flexibility moderate the relationship between weight loss and depression reduction, such that individuals who lose weight AND increase psychological flexibility experience significantly greater reductions in depression than those who lose weight alone.

If you are doing a weight loss program, don't just focus on the scale. Pay attention to your ability to stay committed to your goals even when it feels hard or uncomfortable (psychological flexibility). The research shows that people who get better at this mental skill while losing weight see much bigger improvements in their depression than those who just lose weight. Consider adding mindfulness or acceptance-based strategies to your routine to boost mental health outcomes.

Elevated diabetes-related emotional distress is significantly associated with poorer glycemic control, even among patients who otherwise maintain medication adherence.

Recognize that emotional stress about diabetes can directly worsen blood sugar levels. If you feel distressed, discuss it with your healthcare team. Managing your mental health is as important as managing your diet and medication for achieving good glycemic control.

Lower socioeconomic status is significantly associated with poorer glycemic control in urban Indian patients with Type 2 Diabetes.

Financial and social factors play a significant role in blood sugar control. If cost is a barrier, discuss this with your doctor. They may be able to suggest lower-cost alternatives or connect you with resources to help manage your diabetes.

High socioeconomic status, structured education (>6 sessions), therapeutic adherence, and frequent self-monitoring of blood glucose (>4/day) are independent predictors of achieving optimal metabolic control in diabetes.

To get the best results from your diabetes treatment, you need more than just pills. You need to take them consistently, monitor your blood sugar frequently (more than 4 times a day), and engage in structured education. If you have financial or social barriers, seek support, as these factors significantly impact your ability to control your blood sugar.

Broadening obesity treatment goals beyond weight loss to include obesity-related diseases, health-related quality of life (HrQoL), body image, and weight bias internalization (WBI) improves patient-centered care and treatment adherence.

When starting obesity treatment, discuss your goals beyond just weight loss. Ask your provider about improvements in energy, pain, mood, or disease markers. If you are motivated by appearance, be open about this so your care team can address body image concerns proactively, which may include counseling. This helps ensure the treatment plan aligns with what matters most to you, increasing your chances of sticking with it.

Dietary guidelines should prioritize the NOVA classification (degree of processing) over nutrient profiling to effectively reduce diet-related disease.

Advocate for or follow dietary guidelines that emphasize eating fresh meals and avoiding ultra-processed products, rather than focusing solely on macronutrient ratios or calorie counts.

Remote behavioral weight loss interventions yield superior weight loss outcomes for Black women compared to in-person interventions, whereas in-person interventions are more effective for white women.

If you are a Black woman seeking weight loss support, a remote program (phone/web) may be more effective for you than a traditional in-person group class. The study shows Black women lost more weight (-3.0%) with remote support compared to in-person (-2.0%), while white women did better in person. Remote options offer flexibility for busy schedules and may reduce the stress of group dynamics. If you are a white woman, in-person support might yield better results (-7.2% vs -4.4%).

Smoking, overweight (BMI ≥24), and physical inactivity are independent risk factors for stroke, increasing risk by 1.18-1.22 fold and 1.75 fold respectively compared to non-smokers, normal weight, and active individuals.

Avoid smoking, maintain a healthy weight (BMI <24), and engage in regular physical activity (moderate or vigorous exercise ≥30 minutes, ≥3 times/week). These three factors are independently associated with a significantly lower risk of stroke. Focus on quitting smoking, managing weight, and staying active to protect your cardiovascular health.

Urbanization disproportionately reduces occupational and household physical activity, while potentially increasing transport and recreational activity in High-Income Countries.

In urban areas, your job and home chores likely provide less physical activity than they did in rural settings. To maintain health, you must intentionally engage in leisure-time exercise or active transport, as urbanization naturally shifts you away from labor-intensive activities.

Strength training protocols for people with haemophilia are frequently under-reported regarding critical safety and efficacy variables, specifically pain threshold, prophylactic factor coverage, intensity, range of motion, and time under tension.

If you have haemophilia and are doing strength training, ensure your protocol clearly specifies pain limits (like a 0-2/10 scale), how your clotting factor treatment aligns with exercise days, and the exact intensity and range of motion. This transparency is crucial for safety and effectiveness, as current practices often omit these details.

Obesity stigma independently worsens mental and physical health outcomes, increases cortisol and oxidative stress, and promotes weight gain through avoidance of healthcare and unhealthy coping behaviors.

If you have obesity, know that stigma is a major barrier to your health, not a motivator. Avoiding doctors due to fear of judgment often leads to worse health outcomes. Seek providers who use 'people-first' language and focus on your overall well-being rather than just your weight. This reduces stress and improves adherence to treatment.

Implementing patient-centered care and 'people-first' language reduces stigma, improves patient adherence, and enhances therapeutic outcomes in obesity management.

Healthcare providers should use 'people-first' language (e.g., 'patient with obesity' instead of 'obese patient') and focus on the patient's perspective. This builds trust, reduces stigma, and improves the patient's likelihood of adhering to lifestyle, pharmacological, or surgical treatments.

Addressing mental health issues, particularly depression and anxiety, through screening and intervention improves glycemic control in patients with Type 2 Diabetes.

If you are struggling with depression or anxiety, talk to your healthcare provider. Treating mental health issues can help you manage your diabetes better and improve your blood sugar levels. Pharmacists can help screen for these issues and refer you to appropriate resources.

The updated CG189 NICE guidelines recommend self-measurement of waist-to-height ratio (target ≥0.5) for adults with BMI <35 kg/m2 to assess abdominal fat and health risk, shifting focus from BMI alone.

If your BMI is under 35, measure your waist and divide it by your height. If the number is 0.5 or higher, you have increased health risk from abdominal fat. Share this number with your doctor to discuss next steps, rather than relying on BMI alone.