Browse the evidence

Combining direct patient mailings with in-clinic provider referrals significantly enhances the reach and representativeness of primary care behavioral weight loss interventions compared to passive or low-engagement strategies.

To successfully recruit patients into weight loss programs, primary care clinics should use a dual approach: send targeted mailings to eligible patients and actively encourage providers to make direct referrals during visits. This combination is more effective than either method alone, especially for reaching diverse populations. Providers should be supported with easy-to-use referral tools to minimize the time burden and ensure consistent outreach.

Individuals with unhealthy pre-pandemic lifestyle patterns (low diet quality, low physical activity) are more likely to improve their diet quality and lose weight during periods of high lifestyle disruption compared to those with healthy pre-pandemic patterns.

If you currently have unhealthy habits, a major life disruption (like a pandemic or job loss) might actually be the catalyst you need to improve your diet and lose weight, simply because you have more room to improve than someone who was already healthy. Focus on small, sustainable changes to diet quality and physical activity, as these are the key drivers of weight change during disruption.

Programmatic facilitators for SERD adherence include group counseling, emotionally supportive clinical staff, and social network support, while barriers include product unpalatability, unrealistic expectations, and externalized stigma.

To maximize adherence to a SERD, patients should seek programs that offer group counseling, emotionally supportive staff, and a non-judgmental physical environment. Addressing product unpalatability and setting realistic weight loss expectations are key to overcoming common barriers.

Progressive overload in cardiac rehabilitation is achieved primarily through increasing exercise duration rather than intensity, resulting in suboptimal cardiorespiratory fitness improvements.

For cardiac rehab, simply doing more minutes of exercise isn't enough if the intensity stays the same. To improve fitness, you must increase the effort (heart rate/resistance) as you get fitter, not just the time spent. Relying solely on duration leads to minimal fitness gains.

Home-based training (HBT) is an effective alternative to supervised exercise training when SET is not feasible, provided it is monitored.

If you can't go to a supervised clinic, do home-based walking exercises. Start with 20 minutes and build up to 60 minutes, 3 times a week. Use a pedometer, smartwatch, or logbook to track your activity. This is a valid alternative to supervised training.

Higher cardiorespiratory fitness (CRF) is independently associated with more favorable left ventricular contractility (lower Ecc), independent of visceral fat levels and other risk factors.

Prioritize improving your cardiorespiratory fitness (VO2max) through structured aerobic exercise, not just general daily movement. Higher fitness protects heart muscle function independently of how much belly fat you have.

Prolonged sitting is an independent risk factor for Type 2 Diabetes, cardiovascular mortality, and all-cause mortality.

Break up long periods of sitting by standing or moving for a few minutes every 90 minutes to reduce your risk of diabetes and heart disease.

Lower intertemporal discount rates (higher patience) are associated with the selection of foods with higher nutritional quality, independent of active health consideration.

People who are naturally more patient (low discounters) tend to choose healthier foods. This trait is stable but can be influenced by interventions like episodic future thinking, which asks individuals to imagine detailed future experiences, thereby reducing impulsive choices and promoting healthier diets.

Actively considering health outcomes during food choice leads to longer decision times, increased use of nutrition information, and consideration of healthier product sets, distinguishing it from habitual decision-making.

Healthy choices often require more time and effort than habitual ones. If you find yourself spending more time looking at labels and considering health impacts, this is a sign of active, model-based decision-making that leads to better outcomes. You can facilitate this by using simple visual cues that make health information easy to process, reducing the cognitive load.

Counselor efficiency in providing personalized feedback for technology-based behavioral weight loss interventions increases significantly over the first 9 months, reducing the time required per feedback message from a mean of 53 minutes to 26 minutes, though the absolute time cost (25-30 minutes) remains high.

If you are designing a weight loss program with human coaching, expect the time required to review and respond to participant data to drop significantly after the first 3-6 months as counselors become proficient. However, even with this efficiency gain, the time cost per interaction remains substantial (approx. 25-30 minutes), suggesting that for large-scale programs, hybrid models using automated feedback or peer support may be necessary to maintain cost-effectiveness.

Intermittent diet breaks may reduce psychological disinhibition (loss of control over eating) compared to continuous energy restriction, although this comes at the cost of a longer total intervention duration.

If you struggle with losing control over your eating (disinhibition) while dieting, scheduled diet breaks might help you stay more in control psychologically than continuous dieting. However, this strategy requires 8 weeks to achieve what continuous dieting does in 6 weeks, so you must be willing to extend your total dieting time.

The Edmonton Obesity Staging System (EOSS) provides a more comprehensive clinical management framework than BMI alone by categorizing obesity based on health complications.

Ask your doctor to use the Edmonton Obesity Staging System (EOSS) to evaluate your health. This focuses on your specific complications rather than just your weight.

Time-restricted feeding (TRF) and alternative-day fasting (ADF) reduce body weight and improve lipid profiles in NAFLD patients, but TRF offers no additional benefit over daily caloric restriction regarding intrahepatic triglyceride reduction when caloric deficit is matched.

If you have fatty liver, losing weight is the most effective treatment. Time-restricted feeding (eating only between 8am and 4pm) can help you lose weight, but it does not reduce liver fat more than simply counting calories and eating less throughout the day. Choose the method that you can sustain long-term.

Higher baseline physical activity engagement during early pregnancy predicts continued moderate physical activity in the third trimester, regardless of BMI or military status.

If you are pregnant and want to stay active, getting started with moderate physical activity early in pregnancy (before 12 weeks) is the best way to ensure you keep doing it later in pregnancy. Your early habits strongly predict your later habits, more so than your weight or job status.

Athletes who purchase nutritional supplements outside of their athletic department's provided inventory are at significantly higher risk of using non-third-party tested (TPT) supplements compared to those who rely on department-provided products.

If you buy supplements from your school's athletic department, you are statistically much safer regarding contamination risks than if you buy them yourself at a store or online. If you must buy your own, you are at higher risk of using untested products; prioritize finding and ordering from verified third-party tested sources.

Using caffeine supplements is associated with a significantly higher risk of using non-third-party tested supplements compared to other supplement types.

If you use caffeine supplements, you are at the highest risk of using untested products. Be extra vigilant: look for third-party testing logos (NSF, Informed Choice) on caffeine products, especially pre-workouts, as they are frequently adulterated.

Advanced resistance training systems (Rest-Pause and Sarcoplasmic Stimulating Training) induce significantly higher perceived exertion, pain, and displeasure compared to traditional multi-set training, despite producing lower post-exercise lactate concentrations.

If you are an experienced lifter, advanced techniques like Rest-Pause or Sarcoplasmic Stimulating Training can increase your total training load and volume, which are key for muscle growth. However, be aware that these methods will feel significantly more painful and unpleasant than standard training, even if they produce less lactate. Because of this high discomfort, these systems are best reserved for experienced athletes who can tolerate the psychological burden, rather than beginners.

For non-resistance trained women, distributing resistance training volume across four weekly split-body sessions yields equivalent maximal strength, muscle mass, and explosive power gains compared to two weekly full-body sessions, provided total weekly volume is equated.

If you are new to resistance training, you do not need to commit to four gym days a week to get strong or build muscle. You can achieve the same results with just two full-body sessions per week, as long as you perform the same total amount of work (sets and reps). Choose the schedule that fits your life best, as forcing four sessions may lead to dropping out.

Performing one long resistance training session results in higher perceived effort and discomfort, but also higher session pleasure and preference compared to splitting the same workout into two shorter sessions.

If you enjoy feeling like you've worked hard, do one long session. If you prefer to feel less uncomfortable during the workout, split it. Both approaches are valid; choose based on your psychological preference.

A high-protein breakfast (34g) significantly increases subjective satiety and reduces hunger compared to a low-protein breakfast (6g) in young women with overweight, but this does not translate to reduced daily energy intake.

If you switch to a high-protein breakfast, you will likely feel fuller and less hungry in the hours after eating. However, be aware that this feeling of fullness may not automatically lead to eating less food throughout the rest of the day, as this study showed no difference in total daily energy intake.

Synchronous remote weight management interventions for adults with excess weight (BMI ≥ 27.5 kg/m2) face significant engagement barriers including privacy concerns, time burden, technical issues, and digital exclusion, which can be mitigated by facilitators such as digital competency, tailored feedback, convenience, and professional support.

To succeed with a remote weight management program, prioritize platforms that offer strong privacy protections, ease of use, and professional support. Address technical barriers by ensuring you have reliable internet and basic digital skills. Leverage features like self-monitoring and tailored feedback to maintain engagement, as these are key facilitators identified in the research.

The effectiveness of interventions on fiber intake diminishes over time, with higher effects observed at 9-24 months compared to 36 months and beyond.

If you join a dietary program, expect the biggest benefits in the first two years. To maintain these benefits long-term, you need to connect the program's lessons to your daily life and ongoing support systems, as the structured intervention's effect fades after 3 years.

Moderate or severe gastrointestinal (GI) adverse events during GLP-1 RA treatment are associated with a higher hazard of discontinuation and a lower rate of reinitiation.

GI side effects are a common reason for stopping GLP-1 RA. If you experience moderate or severe GI issues, talk to your provider about management strategies. These side effects are linked to higher discontinuation rates, but they can often be mitigated to help you stay on the medication.

Intermittent empagliflozin administration (up to 14 days/month) improves dietary self-management and reduces energy intake in type 2 diabetes patients, achieving HbA1c and weight loss outcomes equivalent to daily administration.

For type 2 diabetes patients struggling with daily medication adherence or dietary control, an intermittent empagliflozin regimen (10mg, up to 14 days/month) may be a viable strategy. This approach allows patients to take the medication on days they perceive their diet was poor, potentially improving their overall dietary self-management and motivation. Clinical results (HbA1c and weight loss) were equivalent to daily dosing, suggesting that this flexible approach can maintain efficacy while reducing the burden of daily medication.