Browse the evidence

Anti-obesity medications should be used as part of a multidisciplinary approach that includes lifestyle changes, behavioral management, and long-term follow-up, rather than as a standalone solution.

Medication is a tool, not a cure. It works best when combined with healthy eating, physical activity, and behavioral support. Your doctor will likely recommend a multidisciplinary approach to ensure long-term success.

Integrating dietary quality improvements with behavioral strategies focused on everyday-life agency and self-management capacity yields stronger effects on glucose control and dietary quality than standard counseling or single-modality interventions.

To manage Type 2 Diabetes effectively, move beyond just counting carbs or calories. Focus on building your ability to manage your health within your actual daily life and social situations. This involves active learning and developing 'agency' over your eating habits, supported by regular check-ins with healthcare providers, rather than just receiving static dietary advice.

Adding supportive accountability components (introductory video call, drop-in webchat, goal setting, food diary review) to a core digital behavioral weight loss program is hypothesized to enhance weight loss and engagement by increasing participant adherence through trust and accountability.

To get the most out of a digital weight loss program, look for one that offers flexible, on-demand access to a coach (like chat or video) and structured goal-setting. These features help keep you accountable without being overwhelming, which is key to sticking with the program long enough to lose weight.

A one-year person-centered and culturally sensitive intervention, incorporating continuous glucose monitoring (CGM) and extended healthcare provider time, improves glycemic control (HbA1c) and diabetes management in individuals with Type 2 Diabetes and non-Western backgrounds compared to usual care.

For individuals with Type 2 Diabetes from non-Western backgrounds, standard care may not be enough due to cultural and language barriers. This protocol suggests a specialized, one-year program that uses continuous glucose monitors (CGM) and culturally tailored education in native languages (Arabic, Turkish, Urdu). The key is building a long-term relationship with the same healthcare team to improve trust, understanding, and glycemic control.

Integrating intermittent Continuous Glucose Monitoring (CGM) with culturally-informed kaiāwhina support and optimized clinical care significantly reduces HbA1c levels in patients with Type 2 Diabetes compared to usual care.

For patients with Type 2 Diabetes who struggle with standard care, combining continuous glucose monitoring (CGM) with culturally tailored support (kaiāwhina) and optimized medical management can significantly improve blood sugar control. This approach addresses both the technical aspect of glucose tracking and the social/cultural barriers to care.

A 36-month complex lifestyle intervention combining digital tools, face-to-face group education, and individual consultations significantly reduces the incidence of type 2 diabetes in adults with prediabetes compared to usual care.

If you have prediabetes, a structured program combining regular group education, personal coaching, and digital tracking over 3 years is designed to help you lose weight, eat healthier, and exercise more to prevent diabetes. This approach is more comprehensive than digital tools alone.

Consuming non-nutritive sweetened (NNS) beverages as part of a structured behavioral weight loss program leads to significantly greater weight loss and maintenance compared to consuming water, specifically among regular NNS users.

If you are a regular user of diet drinks, you do not need to switch to water to lose weight. In fact, sticking with diet drinks while following a structured weight loss plan may help you lose more weight than switching to water, likely because it satisfies your sweet taste preference without adding calories.

Sustained lifestyle interventions targeting physical activity and dietary changes significantly reduce cardiovascular disease morbidity and mortality in adults, with long-term adherence being critical to maximizing these benefits.

To reduce your risk of heart disease and stroke, focus on making lasting changes to your diet and physical activity levels. While starting these changes is important, sticking with them over the long term is what truly lowers your risk and improves your quality of life.

Achieving significant weight loss (≥10%) in the first year of a lifestyle intervention is a strong predictor of maintaining that loss at 4 years.

Focus on achieving significant weight loss in the first year, as this is the strongest predictor of long-term success. However, even if you don't lose much initially, staying engaged with the program and adhering to behavioral strategies can still lead to positive outcomes.

Higher treatment attendance, greater physical activity, and lower calorie intake are associated with the maintenance of ≥10% weight loss over 4 years.

To maintain weight loss, prioritize regular attendance at counseling sessions, engage in at least 175 minutes of moderate physical activity per week, and maintain a calorie-controlled diet. These behaviors are strongly linked to long-term success.

Mobile interventions (text messages, apps) significantly improve physical activity and reduce adiposity.

Use mobile apps or text message programs to boost your physical activity and manage your weight. These tools are effective and can be integrated into your daily life.

Internet interventions significantly reduce excessive alcohol use.

Use internet-based programs to help you reduce your alcohol consumption. These programs offer personalized feedback and support, which can help you drink less.

Intensive lifestyle intervention (ILI) preserves physical health-related quality of life (HRQoL) by slowing the age-related decline in physical functioning compared to standard diabetes support and education (DSE) in overweight/obese individuals with type 2 diabetes.

For those with type 2 diabetes, committing to a structured lifestyle program can help maintain physical function and quality of life over the long term, even if it doesn't drastically reverse age-related decline. The key benefit is slowing the rate of physical deterioration compared to those receiving standard care.

Intensive lifestyle intervention (ILI) does not significantly reduce the use of antidepressant medications (ADMs) compared to diabetes support and education (DSE) in overweight/obese individuals with type 2 diabetes.

While ILI reduces the risk of developing new depression symptoms, it does not necessarily lead to a reduction in the use of antidepressant medications for those already taking them. Clinicians should not expect ILI to replace pharmacological treatment for existing depression.

Combining structured exercise with wearable technology interventions to reduce sedentary behavior and increase non-exercise physical activity (NEPA) is hypothesized to reduce cardiovascular disease (CVD) risk in older adults more effectively than exercise alone.

If you are an older adult at risk for heart disease, structured exercise is important but may not be enough on its own. Try to use a wearable activity monitor to track your daily movement and consciously break up long periods of sitting. Increasing your 'non-exercise' movement (like standing, walking around the house) can help lower your cardiovascular risk.

A 1-year person-centered and culturally sensitive intervention, including continuous glucose monitoring and extended healthcare professional consultations, improves glycemic control (HbA1c) and diabetes management in non-Western, Arabic-, Turkish-, or Urdu-speaking individuals with Type 2 Diabetes compared to usual care.

For individuals with Type 2 Diabetes from Arabic, Turkish, or Urdu-speaking backgrounds, standard care may not be enough. This protocol suggests seeking a specialized, culturally sensitive program that includes continuous glucose monitoring, extended consultations with the same healthcare team, and education in your native language. This approach aims to improve blood sugar control and overall well-being by addressing language barriers and cultural needs.

Cohabiting with a partner receiving tirzepatide pharmacotherapy can induce significant weight loss and metabolic improvement in an untreated spouse through vicarious efficacy driven by shared environmental and behavioral changes.

If you are starting tirzepatide and live with a partner who has metabolic issues, your changes to food shopping and cooking habits may significantly benefit them too. Encourage your partner to monitor their health metrics, as they may see improvements in weight and blood sugar without needing medication themselves. Discuss these changes openly to ensure both partners are comfortable with the household shifts.

Psychological and behavioral therapies, specifically stimulus control, sleep restriction, relaxation, paradoxical intention, and cognitive-behavior therapy, produce reliable and clinically significant improvements in sleep parameters for individuals with primary or comorbid insomnia.

If you struggle with persistent insomnia, prioritize evidence-based behavioral therapies like Cognitive Behavioral Therapy for Insomnia (CBT-I) over long-term medication use. These therapies, which include stimulus control and sleep restriction, are proven to improve sleep quality and allow many patients to discontinue hypnotic medications safely. Consult a sleep specialist to access these empirically-supported treatments.

Closed kinetic chain (CKC) quadriceps exercises are preferred over open kinetic chain (OKC) exercises in the first 6 weeks after ACL reconstruction with bone-patellar tendon-bone (BPTB) grafts, as OKC exercises may increase graft laxity.

If you had your ACL reconstructed with a bone-patellar tendon-bone graft, avoid open kinetic chain exercises (like straight leg extensions) for the first 6 weeks. Instead, focus on closed kinetic chain exercises (like squats or lunges) as they are safer for your graft and lead to better knee function. If you had a hamstring graft, you might be able to start limited open chain exercises after 4 weeks, but only within a specific range of motion.

Automated, semipersonalized text messaging interventions significantly improve multiple cardiovascular risk factors (LDL-C, blood pressure, BMI, physical activity, and smoking cessation) in patients with coronary heart disease compared to usual care.

If you have heart disease, receiving regular, personalized text messages about diet, exercise, and smoking can help you lower your cholesterol, blood pressure, and weight, and quit smoking. This simple, low-cost tool works by keeping healthy habits top-of-mind without requiring complex apps or smartphones. It is most effective when combined with your usual medical care.

Cognitive-behavioral therapy for insomnia (CBT-I) is recommended as the first-line treatment for chronic insomnia in adults, regardless of comorbidities, and can be delivered face-to-face or digitally.

If you have chronic insomnia, seek Cognitive Behavioral Therapy for Insomnia (CBT-I) as your primary treatment. It can be done in person with a therapist or via a guided digital app. This is the most effective first-line treatment for adults, even if you have other health conditions.

Exercise interventions significantly reduce depressive symptoms in adults with major depressive disorder or clinically elevated depressive symptoms compared to non-active controls.

If you are struggling with depression, engaging in supervised, moderate-intensity aerobic or resistance exercise is a clinically effective treatment. You do not need to commit to long-term programs to see benefits; shorter interventions (under 16 weeks) may actually yield larger symptom reductions. Aim for group settings if possible, as these showed large effects.

Internet-delivered Cognitive Behavioral Therapy for Insomnia (iCBTI) significantly improves sleep efficiency, total sleep time, and insomnia severity compared to waitlist controls in adults.

If you have insomnia, internet-delivered CBTI is a valid, evidence-based treatment option that is as effective as seeing a therapist in person. Look for programs that include core CBTI elements like sleep restriction and stimulus control. These programs typically run for 5-9 weeks and can be self-directed or guided by a therapist via email/phone. This approach is particularly useful if you cannot access in-person specialists.

Internet-delivered CBTI leads to durable improvements in sleep efficiency and insomnia severity that are maintained for up to 48 weeks post-treatment.

The benefits of iCBTI are not just short-term. Improvements in sleep efficiency and reduced insomnia severity tend to last for at least 4 to 48 weeks after finishing the program, suggesting that the behavioral changes learned are durable.