Browse the evidence

An intensive start with combined diet and supervised circuit weight training (0-3 months) significantly enhances long-term waist circumference reduction compared to delayed exercise or behavioral modification alone.

If you are starting a weight loss journey, especially if you have obesity, start with an intensive program that includes both diet and supervised exercise from day one. This study suggests that adding structured exercise (like circuit training) in the first 3 months leads to significantly better long-term reduction in waist circumference than starting exercise later or doing diet alone. The early success helps maintain motivation and adherence over the next few years.

Intensive behavioral modification (diet and counseling) alone results in clinically significant long-term weight loss and maintenance, even without added exercise.

You can achieve significant long-term weight loss through intensive behavioral modification alone, without needing to add structured exercise. This involves regular counseling, self-monitoring with food/activity diaries, and a moderate caloric deficit (500-1000 kcal/day). This approach resulted in an average 6.8% weight loss maintained over 3 years.

Providing personalized biofeedback on resting energy expenditure (REE) and respiratory quotient (RQ) via portable indirect calorimetry significantly enhances weight loss outcomes compared to standard care alone in individuals with obesity.

If you have obesity, asking for a metabolic test (indirect calorimetry) during your weight loss program can help you lose more weight than standard advice alone. This test measures how you burn fat vs. carbs and your resting energy needs. Share these results with your dietitian so they can tailor your calorie and exercise goals to your specific biology, rather than using generic formulas. This personalized approach led to significantly greater weight loss and waist circumference reduction in this study.

A 12-month 4:3 intermittent fasting protocol significantly reduces binge eating and uncontrolled eating behaviors compared to daily caloric restriction, and these behavioral improvements are associated with greater weight loss.

If you struggle with binge eating or losing control over food intake, try a 4:3 intermittent fasting schedule (fasting for 3 non-consecutive days a week with significant calorie restriction, and eating normally for the other 4 days) combined with behavioral support. This approach may help reduce binge eating tendencies more effectively than strict daily calorie counting, potentially leading to better long-term weight loss.

Intermittent Caloric Restriction (ICR), specifically Alternate Day Fasting (ADF), is as effective as Continuous Caloric Restriction (CCR) for weight loss but offers superior compliance and lean mass retention.

Try Alternate Day Fasting: Eat normally on one day, then restrict calories significantly (or fast) the next. This method is just as effective for weight loss as daily calorie counting but may be easier to stick to because you aren't restricted every day.

Higher adherence to the VLCKD program, measured by number of medical visits and total doses consumed, is positively associated with greater success in weight loss, BMI reduction, and fat mass loss.

Attend all scheduled medical and nutritional visits. The study shows that higher adherence, measured by attending visits and consuming the prescribed doses, is significantly associated with better weight loss and fat loss outcomes.

Consumption of fermentable fibers (e.g., inulin, FOS, wheat dextrin) increases satiety and reduces caloric intake, leading to modest weight loss over time.

To manage weight, incorporate 14-24 grams of fermentable fiber like wheat dextrin daily. This dose has been shown to significantly reduce hunger and caloric intake over 9 weeks. Start with a lower dose to assess tolerance, as some fibers cause GI distress while others like wheat dextrin are well-tolerated.

Adopting a combination of healthy lifestyle habits—maintaining desirable body weight, eating a healthy diet, exercising regularly, not smoking, and consuming moderate alcohol—can reduce the risk of cardiovascular disease by 84%.

To significantly lower your heart disease risk, focus on five key areas: keep your weight in a healthy range, eat a balanced diet, exercise regularly, do not smoke, and if you drink alcohol, do so in moderation. These combined lifestyle changes are the most powerful tool for primary prevention.

Intensive lifestyle interventions, specifically achieving recommended levels of moderate physical activity, prevent or delay the onset of type 2 diabetes in high-risk individuals.

If you are at risk for Type 2 diabetes, focus on getting moderate physical activity regularly. You do not need extreme workouts; achieving recommended levels of moderate activity can reduce your risk of developing diabetes by about 30% compared to being inactive. Combine this with healthy eating habits for the best prevention.

Resistance training interventions can partially reverse age-related strength losses and attenuate the decline in muscle cross-sectional area in elderly populations.

Start or continue resistance training. It doesn't matter how old you are; you can still gain strength and muscle mass. Even starting later in life can help you maintain independence and reduce the risk of falls.

Exercise involving resistance training and/or weight-bearing aerobic exercise is recommended for those with or at risk for osteoporosis to improve physical function, pain, muscle strength, and balance.

Do not avoid exercise due to fear of breaking a bone. Engage in resistance training and weight-bearing aerobic exercises suitable for your ability. This strengthens muscles and balance, which helps prevent falls and improves how you feel daily.

High chronic training loads have a protective effect against injury, whereas rapid week-to-week increases in training load (spikes) significantly increase injury risk.

Do not simply reduce training load to prevent injuries. Instead, monitor the ratio of this week's load to the average of the last 3-6 weeks (acute:chronic ratio). Keep this ratio between 0.8 and 1.3. If you must increase load, do it gradually (less than 10% week-to-week) to allow the body to adapt and build resilience without spiking injury risk.

The acute:chronic workload ratio (ACWR) is a valid predictor of injury risk, with ratios between 0.8 and 1.3 representing a 'sweet spot' for low injury risk, and ratios >= 1.5 representing a 'danger zone'.

Calculate your athlete's average load from the past 3-6 weeks (chronic). Compare this week's load (acute) to that average. If the ratio is above 1.5, you are in the 'danger zone' and likely to cause injury. Aim to keep the ratio between 0.8 and 1.3. If the ratio is below 0.8, the athlete may be detraining and also at increased risk.

Autonomous motivation for weight loss (internalized regulation) predicts higher program attendance, greater weight loss during intervention, and greater maintenance of weight loss at 23-month follow-up compared to controlled motivation.

To lose weight and keep it off, focus on why you are doing it. If you are dieting because you feel forced, guilty, or pressured by others, you are likely to quit when the pressure eases. Instead, connect your weight loss goals to your own personal values and health desires. This internal 'why' (autonomous motivation) is what keeps you attending appointments and sticking to the plan long-term.

Lifestyle modification, including diet, physical activity, and behavior therapy, is the cornerstone of obesity management and can lead to significant weight loss and reduced cardiovascular risk.

Lifestyle modification is the primary and most effective way to manage obesity. This involves a combination of diet, physical activity, and behavior therapy. Aim to lose at least 10% of your body weight through these changes. If lifestyle changes alone are not enough, consult a healthcare provider about other options like pharmacotherapy or surgery.

Exercise serves as a therapeutic agent and preventative medicine that can substitute for or reduce the need for potentially inappropriate medications (PIMs) such as antidepressants, anxiolytics, and insomniacs in older adults, thereby reducing adverse drug events like falls and cognitive impairment.

If you are taking medications for depression, anxiety, or insomnia, talk to your doctor about whether exercise could help reduce your dose. Exercise is a proven treatment that can improve your mood and sleep without the side effects of these medications, such as increased risk of falls or confusion.

Regular physical activity (defined as walking or cycling for 2 or more hours per week) reduces the risk of hospital admission for COPD and all-cause mortality in patients with chronic obstructive pulmonary disease.

If you have COPD, aim to walk or cycle for at least 2 hours a week. You do not need intense gym workouts; light to moderate activity like walking is sufficient. This level of activity is associated with a significant reduction in hospital visits and death. Start slowly and focus on consistency rather than intensity.

For healthy adults, 10,000 steps per day is a reasonable target that aligns with public health guidelines for moderate-to-vigorous physical activity (MVPA), whereas less than 5,000 steps/day indicates a sedentary lifestyle.

Aim for 10,000 steps a day. This isn't just a random number; it roughly equals 30 minutes of brisk walking (where you take at least 100 steps per minute) on top of your normal daily movement. If you currently take 5,000 steps, try adding 2,000-2,500 steps gradually. Ensure those extra steps are taken in chunks of at least 10 minutes to count toward your health benefits.

Reallocating time from sedentary behavior (SB) to moderate-to-vigorous physical activity (MVPA) significantly improves cardiometabolic health markers, with MVPA being the strongest positive predictor of health outcomes.

Prioritize moving time from sitting (SB) to moderate-to-vigorous activity (MVPA). Even small shifts, like 10 minutes, can improve waist circumference and other health markers. MVPA is the most impactful behavior for health; reducing sedentary time by replacing it with MVPA is more effective than just adding light activity.

Replacing sedentary behavior (SB) with light-intensity physical activity (LIPA) is associated with more favorable diabetes risk markers.

If you cannot perform vigorous exercise, replacing sitting time with light activity (like walking slowly) can still improve diabetes risk markers. It is better to be lightly active than sedentary.

Higher levels of physical activity significantly reduce the prospective risk of incident depression, with effects persisting across age groups and geographic regions.

To lower your risk of depression, aim for higher levels of physical activity. This doesn't necessarily mean intense gym sessions; regular movement, including walking, cycling, or swimming, has been shown to reduce the risk of developing depression across all age groups. Consistency matters more than intensity for this preventive benefit.

Adding exercise or behavior therapy to a diet improves weight loss and risk factors for at least 1 year.

Combine your diet with exercise or behavior therapy to get better weight loss and risk factor improvements for at least a year compared to diet alone.

Regular physical activity in older adults (aged 60+) significantly reduces all-cause mortality, with each additional 15 minutes of daily activity up to 100 minutes per day resulting in a 4% decrease in mortality risk.

If you are over 60, aim to add 15 minutes of daily physical activity to your routine. You do not need to reach 100 minutes to see benefits; every 15-minute increment you add reduces your risk of death by 4%. Start small and build up.

Adapting Cognitive Behavioral Therapy for Insomnia (CBT-I) elements—specifically stimulus control, sleep restriction, and cognitive interventions—is the primary effective treatment for managing sleep problems during home confinement, with pharmacotherapy reserved only for short-term use when CBT-I is ineffective or unavailable.

Treat your sleep like a skill, not a switch. Go to bed only when you are sleepy, and get up at the same time every day, regardless of how much you slept. If you can't sleep, get out of bed and do something boring in dim light until you are sleepy again. Do not work, eat, or watch TV in bed. If stress is keeping you up, schedule 15 minutes earlier in the day to write down your worries, so they don't interfere with night-time sleep. Reserve medication for severe, short-term cases only, and only after trying these behavioral steps.