Browse the evidence

Increasing primary care provider (PCP) referral rates for weight loss surgery (WLS) significantly increases the volume of WLS procedures performed, with simulated interventions predicting up to a 24.1% increase in surgeries over 3 years.

If you are eligible for weight loss surgery, your primary care doctor's willingness to refer you is the biggest hurdle. This study suggests that simply encouraging your PCP to refer you to a specialist (endocrinologist or surgeon) significantly increases your chances of eventually having the surgery. If your PCP is hesitant, ask for a referral to a subspecialty obesity clinic, as this is a common stepping stone to surgery.

Bodybuilders primarily rely on fitness coaches and registered dietitians for information regarding dietary supplements, rather than independent medical advice or rigorous scientific literature.

When choosing supplements, prioritize advice from registered dietitians or nutritionists over fitness coaches, as coaches may lack specific nutritional expertise. This reduces the risk of misinformation and adverse effects.

Digital behavioral interventions are as effective as nondigital behavioral interventions for reducing overall cardiovascular risk factors, with no significant difference found across 11 key metrics.

You can use digital tools (apps, wearables, web platforms) to manage heart health risks just as effectively as traditional face-to-face programs or printed materials. The key is consistency and using evidence-based behavioral strategies, regardless of the delivery method.

High-risk patients on blood pressure, lipid, or glucose-lowering medications in primary care settings frequently fail to achieve guideline-recommended lifestyle and medical risk factor targets, indicating a significant gap between evidence-based guidelines and clinical practice.

If you are at high risk for heart disease, taking medication is not enough. You must also address lifestyle factors like smoking, weight, and physical activity. The study shows that most people on medication still fail to reach health targets. Focus on quitting smoking, maintaining a healthy weight, and staying active alongside your medical treatment.

Among patients with severe obesity treated with semaglutide 2.4 mg/week, those with higher intuitive eating scores and lower anxiety/depression levels (Intuitive Eaters Group) achieve significantly greater weight loss than those with higher emotional distress and lower intuitive eating scores (Emotionally Driven Eaters Group).

If you are taking semaglutide for severe obesity, your mental health and eating mindset matter for your results. Patients with high emotional distress and lower intuitive eating skills tend to lose less weight than those with better emotional regulation and intuitive eating habits. To maximize your weight loss, consider integrating psychological support or intuitive eating strategies alongside your medication, as these factors significantly influence your trajectory.

Treatment with the Epitomee shape-shifting hydrogel capsule combined with lifestyle intervention significantly improves health-related quality of life (HRQOL), specifically in Physical Function and total scores, compared to placebo in adults with overweight or obesity.

If you are overweight or have obesity (BMI 27-40) and struggle with portion control, this hydrogel capsule may help improve your quality of life and physical function more than lifestyle changes alone. You take one capsule with a large glass of water 30 minutes before your two main meals daily. It expands in your stomach to help you feel full sooner. This approach is particularly useful if you want to avoid medications or have contraindications to them. The benefits are most pronounced if you lose 10% or more of your body weight, but even modest loss improves physical function scores significantly.

Oral semaglutide is increasingly preferred by younger female patients with fewer comorbidities compared to subcutaneous semaglutide.

If you are a younger woman with few other health issues, you might be more likely to be prescribed oral semaglutide. This form is taken daily as a pill, which some patients prefer over weekly injections. Ensure you follow the specific administration instructions for oral semaglutide (taken on an empty stomach with water) to ensure effectiveness.

Black race and younger age are significantly associated with lower diet quality scores (AHEI-2010 and DASH) in this population, highlighting racial disparities in baseline diet quality.

If you are Black or younger, you may face specific challenges in maintaining a high-quality diet. The study shows these groups often have lower diet quality scores. Interventions should be tailored to address these specific disparities, such as improving access to healthy foods and culturally relevant nutrition education.

Mandibular advancement devices (MADs) provide symptom relief comparable to CPAP in mild-to-moderate OSA primarily due to superior long-term adherence, despite CPAP's superior objective efficacy in reducing AHI.

If you have mild-to-moderate sleep apnea and struggle with CPAP, ask about a mandibular advancement device. It might not reduce your apnea events as much as CPAP, but you are more likely to use it every night, which often leads to better overall health outcomes and symptom relief.

During COVID-19 stay-at-home mandates, older adults with type 2 diabetes experienced significant weight loss (average 2.1%) rather than the weight gain often reported in younger populations.

If you are an older adult with type 2 diabetes, do not assume the pandemic shutdown will automatically cause weight gain. This study found that the majority of participants actually lost weight. However, those who did gain weight reported more negative impacts on their health and access to food, so monitoring your weight and mental well-being is still important.

Among older adults with type 2 diabetes, those who gained weight during the pandemic reported significantly more negative psychosocial and behavioral impacts than those who lost weight.

If you gained weight during the pandemic, you are not alone, but you may be experiencing more stress, sleep issues, or access problems than those who lost weight. Focus on addressing these specific barriers (food access, sleep) rather than just the scale number. If you lost weight, it was likely intentional and not associated with the negative mental health impacts seen in gainers.

Older adults (>30 years) significantly increase their energy intake from ultra-processed foods (UPFs) on weekends compared to weekdays, whereas younger adults (18-30 years) maintain consistent UPF consumption levels regardless of the day of the week.

If you are over 30, your weekend meals are likely driving your high ultra-processed food intake, whereas your weekday habits are stable. To improve your diet, focus your planning efforts specifically on Friday through Sunday. You do not need to change your weekday routine, as your data shows consistency there. Targeting the weekend window is the highest-yield intervention for this demographic.

Younger adults (18-30 years) consume ultra-processed foods (UPFs) in a continuous 'grazing' pattern throughout the day, with distinct peaks at 8 pm and 1 pm, whereas older adults follow conventional three-meal patterns with an additional morning peak.

If you are under 30, you likely snack on ultra-processed foods throughout the day rather than just at meals. Your intake peaks at 1 pm and 8 pm. To reduce UPF intake, focus on eliminating snacks during these specific hours, particularly the late evening peak, rather than just trying to eat 'less' overall.

Physical activity questionnaires (PAQs) and accelerometers demonstrate moderate validity for assessing total physical activity and moderate-to-vigorous physical activity (MVPA) in epidemiologic studies, with PAQs showing particularly strong correlations for vigorous activity.

For researchers and clinicians, using a well-designed physical activity questionnaire (PAQ) is a valid and scalable method for assessing moderate-to-vigorous physical activity in large groups, especially when gold-standard biomarkers like doubly labeled water are too costly. While accelerometers are useful, they may miss certain activities (like swimming or biking) and showed lower validity for vigorous activity compared to PAQs in this study. Combining methods or using validated questionnaires provides a robust estimate of physical activity levels for epidemiological purposes.

New antidiabetic drugs with cardiovascular effects (GLP-1ra and SGLT2-in) are underutilized in primary care due to clinical inertia driven by physician uncertainty, guideline complexity, and patient-specific barriers, despite proven efficacy in reducing cardiovascular morbidity and mortality.

For family physicians managing T2D, prioritize prescribing GLP-1 receptor agonists (GLP-1ra) or SGLT2 inhibitors (SGLT2-in) for patients with established cardiovascular disease, heart failure, or chronic kidney disease, regardless of HbA1c levels. Address clinical inertia by using clinical decision support tools and clear guidelines that define specific indications for these drugs. Discuss cost and side effects (e.g., GI issues for GLP-1ra, genital infections for SGLT2-in) openly with patients to improve adherence.

Psychological therapies (CBT, MANTRA, SSCM, family therapy) and specific pharmacological treatments (fluoxetine, topiramate for BN/BED; lisdexamfetamine for BED) are effective interventions for eating disorders, though RCTs specifically in the military context are lacking.

If you have an eating disorder, rely on evidence-based psychological therapies (like CBT or MANTRA) and prescribed medications (like fluoxetine or lisdexamfetamine) rather than just diet and exercise. These treatments address the root psychological and neurobiological factors of EDs.

Self-directed learning of cooking skills through independent resources (internet, books, TV) significantly increases the likelihood of possessing high cooking skills compared to not using these methods.

If you are a student or busy adult, you can significantly improve your cooking skills by actively seeking out recipes and techniques online, via books, or TV, rather than waiting for formal instruction. This self-directed approach is statistically linked to higher culinary competence, which in turn supports better diet quality and food security.

High availability and accessibility of fruits and vegetables at home is strongly associated with higher cooking skills, likely by providing the necessary ingredients to practice and refine culinary techniques.

To improve your cooking skills, ensure your kitchen has easy access to fruits and vegetables. The study suggests that having these ingredients available encourages you to practice and refine your cooking techniques, leading to higher overall culinary competence.

High knowledge of cooking terms and techniques is associated with higher cooking skills, suggesting that theoretical understanding supports practical culinary competence.

Learn the names of cooking techniques and terms. This theoretical knowledge is not just academic; it is strongly associated with higher practical cooking skills because it builds confidence and provides a mental framework for preparing food.

Primary care clinicians refer approximately 71% of eligible patients (BMI ≥ 30) to intensive behavioral weight loss interventions, but patient enrollment rates remain low (19% of invited, 40.6% of contacted).

If you are in primary care with a BMI over 30, expect your doctor to refer you to a weight loss program if they have a list of patients like you. However, be prepared that enrollment might be low because doctors often prioritize other medical issues or feel they don't know you well enough. To increase your chances, explicitly express interest in weight management during visits.

Relocation to redeveloped low-income housing reduces waist circumference and abdominal obesity, but does not significantly change BMI or overall obesity prevalence.

Moving to a better neighborhood isn't enough on its own; you likely need to move into better housing that facilitates healthier habits (like better kitchens or water quality). Focus on reducing added sugars, as this specific change was linked to waist reduction in this study.

Adherence to intermittent fasting regimens is generally high (>80%) in short-term studies (≤3 months) but drops significantly in long-term studies (>3 months).

Intermittent fasting is easy to stick to for the first 3 months, but adherence drops significantly thereafter. If you plan to fast long-term, expect a drop in adherence and consider modified approaches (like MADF) to sustain it.

A 3-month multicomponent mobile health intervention (smartphone app + smart band + brief counseling) produces statistically significant but clinically modest weight loss and body composition improvements in overweight/obese adults compared to brief counseling alone, but these benefits are not maintained at 12 months after device removal.

Using a smartphone app and fitness tracker for 3 months can help you lose a small amount of weight and improve body composition if you are overweight or obese. However, this benefit disappears after 3 months if you stop using the devices. To maintain weight loss, you must transition the habits learned during the 3-month period (like self-monitoring and dietary awareness) into your daily life without relying on the technology.

Smartphone-only apps for weight management produce a modest but statistically significant reduction in body weight and BMI in adults with overweight or obesity, but this effect is limited to a 4-6 month window and diminishes thereafter due to lack of personalization.

Use a smartphone app for weight loss if you can commit to using it daily for 4-6 months. Expect modest results (SMD -0.33) and be prepared for weight regain if you stop using it. To maximize success, choose an app that offers some level of personalization or feedback, as generic apps have high dropout rates. This is not a long-term solution without human support or advanced AI customization.