Browse the evidence

Weight maintainers in older adults with type 2 diabetes exhibit high variability in physical activity levels, with many maintaining >= 10% weight loss while engaging in less than the recommended 150-250 min/wk of MVPA.

If you have type 2 diabetes and are maintaining your weight, you do not need to force yourself to exercise 4+ hours a week if it is unsustainable. This study shows that many people maintain significant weight loss with less than 150 minutes of moderate-to-vigorous activity per week. Focus on what keeps your weight stable, whether that is moderate activity combined with strict diet, or other lifestyle factors. Do not let the lack of high-volume exercise invalidate your success.

Maintaining non-smoking status, high diet quality, and high leisure-time physical activity significantly reduces the risk of atherothrombotic ischemic stroke, with benefits independent of established comorbidities.

To lower your risk of atherothrombotic stroke, focus on three key behaviors: do not smoke, maintain a high-quality diet (rich in fish, vegetables, fiber, and healthy fats), and engage in high levels of leisure-time physical activity. These benefits hold true even if you have existing conditions like high blood pressure or diabetes. Do not rely on BMI alone as a risk indicator; prioritize these active lifestyle factors.

High consumption of 'savory-fatty' tasting foods is associated with increased total energy intake and overweight status, whereas 'neutral' tasting foods are consumed in lower proportions by high-energy consumers.

Focus on the taste profile of your diet, not just processing levels. High intake of 'savory-fatty' foods (common in many processed dishes) is strongly linked to higher energy consumption and overweight status in this population. To manage weight, consider reducing the proportion of energy derived from savory-fatty clusters and increasing neutral-tasting foods, which were consumed in higher proportions by those with lower energy intake.

The association between sweet taste and sugar content is weaker in ultra-processed foods compared to unprocessed foods, potentially due to the use of non-saccharide sweeteners.

Be aware that sweet taste in ultra-processed foods does not always correlate with high sugar content. Manufacturers may use non-saccharide sweeteners to maintain sweetness while reducing sugar, which can disrupt your body's ability to predict energy intake based on taste alone.

Mandatory menu calorie labeling in US chain restaurants reduces cardiovascular disease and type 2 diabetes incidence, generating net healthcare and societal cost savings.

Support and comply with menu calorie labeling laws. While individual behavior change is modest, the population-level effect prevents thousands of heart attacks and diabetes cases, saving billions in healthcare costs.

Overreliance on BMI as the sole metric for obesity management hinders clinical implementation and confuses clinicians, leading to suboptimal care; waist circumference is a more useful tool for assessing health risk.

Ask your clinician to measure your waist circumference, not just your BMI. This provides better insight into your cardiovascular risk and helps prioritize obesity management interventions.

Pregnant women with obesity exhibit significantly lower physical activity levels compared to general population guidelines, contributing to lower total daily energy expenditure.

Obese pregnant women tend to be significantly less active than recommended, with the vast majority classified as sedentary. Increasing physical activity could be a key intervention to improve energy balance and prevent excessive weight gain.

Physical inactivity and hospitalization-induced bed rest accelerate muscle mass and function loss in older adults at a rate 3-6 times faster than in younger adults, with incomplete recovery.

If you are older, avoid unnecessary bed rest. If hospitalization is unavoidable, ask for early mobilization and physical therapy to mitigate the rapid 3-6x accelerated muscle loss that occurs during inactivity.

Adherence to sulfonylurea (SU) therapy is associated with greater weight gain in patients with type 2 diabetes compared to poor adherence.

If you are prescribed a sulfonylurea for type 2 diabetes, be aware that taking it consistently may lead to weight gain. If weight management is a priority, discuss alternative medications with your healthcare provider that have a weight-neutral or weight-loss effect.

Wrist-worn actigraphy is a valid and recommended objective method for assessing sleep duration and timing, as well as physical activity and sedentary behavior, in obesity research.

For accurate tracking of sleep and activity, use a wrist-worn actigraphy device. It objectively measures your sleep duration and timing, which are linked to energy balance and weight regulation, offering more precise data than self-reports.

Higher program website engagement (meeting a login goal of ≥90 logins in 3 months) significantly decreases the odds of early dropout.

Consistently logging into your weight-loss program's website (aiming for daily logins) is one of the best ways to ensure you stay in the program. If you find yourself skipping logins, it is a warning sign that you might drop out soon.

Having one or more chronic medical conditions significantly increases the odds of early dropout from commercial weight-loss programs.

If you have chronic health conditions, be aware that you are at higher risk for dropping out of weight-loss programs. Proactively communicate with your coach and healthcare provider to manage these competing demands.

A national penny-per-ounce sugar-sweetened beverage (SSB) tax is highly cost-effective for preventing obesity-associated cancers and reducing health disparities among low-income populations in the United States.

Implementing a one-cent-per-ounce tax on sugary drinks is a highly cost-effective strategy to prevent cancer and save healthcare money, especially for low-income Americans. The policy reduces consumption through price elasticity, leading to lower obesity rates and fewer obesity-related cancers.

Patients treated with SGAs show higher cravings for fat and carbohydrates compared to other food types, and exhibit small increases in dietary disinhibition and restrained eating.

SGA treatment is associated with increased cravings for fats and carbohydrates, as well as higher dietary disinhibition (loss of control over eating) and restrained eating (strict dieting). This combination can make weight management difficult. Focus on managing cravings and avoiding extreme restriction, which may backfire, by working with a dietitian to create a sustainable eating plan.

Higher quality primary care consultation experiences (characterized by empathy, listening, and shared decision-making) are associated with a statistically significant increase in the likelihood of Type 2 diabetes remission over a 5-year period.

If you have Type 2 diabetes, actively seek a doctor who listens to you, explains things clearly, and involves you in decision-making. This 'soft skill' of your care is not just nice-to-have; it is statistically linked to a higher chance of reversing your diabetes over 5 years, likely because it helps you stick to the necessary lifestyle changes.

Weight stigma and internalized bias in healthcare settings negatively impact obesity treatment outcomes by reducing care access, increasing weight gain, and causing exercise avoidance, whereas weight-inclusive, body-positive messaging improves exercise intention and adherence.

Healthcare providers should use weight-inclusive language (e.g., 'movement' instead of 'exercise') and create a stigma-free environment. Patients should seek providers who focus on health behaviors rather than just weight loss, as this improves adherence and reduces the psychological burden of obesity.

Remote behavioral weight loss interventions deliver clinically comparable weight loss to in-person interventions at a significantly lower cost per kilogram lost.

If you are looking for a weight loss program, remote support via phone and web tools can be just as effective as meeting in person, but it costs less. The key is sticking to the weekly check-ins and dietary goals, regardless of whether you see a coach face-to-face or over the phone.

Lifestyle interventions for type 2 diabetes prevention in women with a history of gestational diabetes are only effective if they are underpinned by a behavior change theory.

For women with a history of gestational diabetes, lifestyle interventions are most effective at preventing type 2 diabetes when they are designed using established behavior change theories (like Social Cognitive Theory or Health Belief Model). Simple advice without a structured behavioral framework may not be sufficient.

Telemedical lifestyle intervention (TeLIPro) significantly improves HbA1c, body weight, and BMI in Type 2 Diabetes patients with long-standing disease (≥5 years) compared to routine care, but effects are not sustained after coaching ends.

For long-standing Type 2 Diabetes, structured telemedical coaching with self-monitoring (glucose, weight, steps) significantly lowers HbA1c and weight compared to standard care. However, these benefits disappear if coaching stops, suggesting that ongoing support is necessary to maintain metabolic improvements.

Food vouchers restricted to fruits and vegetables, delivered weekly, increase fruit and vegetable intake specifically in low-income adults with moderate baseline consumption (25th-55th percentile), but not in those with very low or very high baseline intake.

If you are designing a food assistance program, do not assume a flat $20 monthly voucher works for everyone. For people who already eat a moderate amount of produce, weekly $5 vouchers for produce only will likely increase their intake. For those who eat very little produce, money alone isn't enough; you must pair the subsidy with education, transportation, or cooking skills. For those who already eat a lot, the subsidy has diminishing returns.

Adherence to digital GLP-1 RA-supported weight loss programs is significantly influenced by patient demographics, with older, Caucasian, and overweight individuals adhering significantly longer than younger, non-Caucasian, and higher BMI-class peers.

If you are using a digital GLP-1 program, be aware that adherence varies by demographic. Older, Caucasian, and overweight individuals in this study tended to stay in the program longer. However, the most common reasons for stopping are cost and side effects. To improve your chances of long-term success, proactively manage side effects with your care team and address financial concerns early, as these are the primary drivers of discontinuation.

In real-world digital weight loss programs combining behavioral therapy and GLP-1 receptor agonists (GLP-1 RAs), inadequate supply of the desired medication is the primary driver of patient discontinuation, outweighing cost and dissatisfaction with outcomes.

If you are using a digital weight loss program that includes GLP-1 medication, expect that medication supply issues are the most common reason for stopping treatment. To stay in the program, be prepared to discuss alternative medications with your care team if your preferred drug is unavailable, rather than discontinuing entirely. Also, consider the total value of the multidisciplinary support (doctors, dietitians, nurses) when evaluating the monthly cost, as cost is the second most common reason for dropping out.

Long-term participation in an intensive lifestyle intervention (ILI) for type 2 diabetes reduces reward-related neural reactivity to high-calorie food cues and enhances attention/visual processing compared to standard diabetes support.

If you have type 2 diabetes and are overweight, sticking to a structured lifestyle program (diet and exercise) for a long period can physically change how your brain reacts to high-calorie foods. Specifically, it may reduce the 'reward' signal and increase your brain's ability to pay attention to and process food cues consciously, which might support long-term weight management.

Online behavioral obesity treatment programs achieve higher implementation success in primary care when they are perceived as having high design quality, low cost, and strong compatibility with clinical workflows.

For primary care clinics adopting online weight loss tools, prioritize programs with clean, intuitive interfaces and zero cost to the provider. Ensure the tool fits seamlessly into existing workflows to avoid being deprioritized due to time constraints.