Browse the evidence

A 12-month weight gain prevention intervention (Shape Program) significantly reduces depressive symptoms in socioeconomically disadvantaged, overweight/obese Black women compared to usual care, independent of weight change.

If you are a Black woman struggling with depression and weight concerns, consider a 'maintain, don't gain' approach. Focus on small, sustainable habits like daily walking and healthy eating without the pressure to lose weight. Regular check-ins with a health coach can provide social support and structure, which may significantly improve your mood independently of weight change.

Increasing cardiorespiratory fitness and losing body mass index (BMI) independently and synergistically slow the progression of deficit accumulation frailty (a marker of biological aging) in adults with type 2 diabetes and overweight/obesity.

If you have type 2 diabetes and are overweight, focusing on improving your aerobic fitness (like brisk walking for >175 minutes a week) and losing weight (targeting >7% loss) can significantly slow biological aging. These two actions work independently: improving fitness helps even if you don't lose much weight, and losing weight helps even if your fitness doesn't change much. Doing both provides the greatest benefit. This applies even if you are over 65.

Participants in a structured, lifestyle-based weight loss program demonstrate a high willingness to pay (median $45/month) for continued intervention, with Black participants showing significantly higher willingness to pay ($65/month) than Non-Black participants ($45/month).

If you are considering a paid weight loss program, know that many participants in the Hopkins POWER trial were willing to pay around $45 per month for continued support, with Black participants willing to pay even more ($65/month). This suggests that structured lifestyle programs offer perceived value comparable to commercial options, regardless of whether you achieved your specific weight loss goal.

The unregulated online sale of sports supplements poses a significant public health risk due to the prevalence of adulterated products containing undeclared prohibited substances.

Be extremely cautious when buying supplements online. The market is poorly regulated, and products may contain undeclared drugs. Look for third-party testing seals or buy from reputable physical stores with known supply chains to avoid contamination.

Parents with children under 18 lose significantly less weight than nonparents in intensive behavioral lifestyle interventions, with the disparity being most pronounced in African American females.

If you are a parent participating in a weight loss program, expect that you may lose less weight than peers without children, even if you try just as hard. This is not a failure of your willpower but a result of logistical barriers and home food environment challenges. To improve outcomes, seek programs that offer flexible scheduling, childcare support, or strategies specifically designed to manage the conflict between children's food preferences and your dietary goals.

Women with severe obesity and PCOS exhibit significantly higher baseline cognitive restraint eating compared to women with severe obesity without PCOS, yet fail to show favorable alterations in eating behaviors (reduced emotional/uncontrolled eating, increased cognitive restraint) after a 12-month structured weight loss intervention, unlike their non-PCOS counterparts.

If you have PCOS and severe obesity, you can lose significant weight (12-14 kg) with a structured intervention, just like women without PCOS. However, standard dietary restriction alone may not change your eating habits (emotional or uncontrolled eating) as effectively. You likely need targeted behavioral support to address emotional eating, not just calorie counting, to maintain the weight loss.

Standardized, detailed reporting of behavioral weight management interventions (BWMIs) using a structured template (STAR-LITE) is necessary to resolve current reporting inconsistencies, enable reliable meta-analysis, and inform effective policy.

If you are designing or evaluating a behavioral weight management program, use a standardized reporting template like STAR-LITE. Document every detail of referral, delivery, components, and costs. This allows your work to be compared with others, included in meta-analyses, and potentially adopted into national guidelines, maximizing its impact and funding potential.

Brief GP-delivered weight loss advice (approx. 86 seconds) results in a statistically significant mean weight loss of 1.04 kg at 12 months compared to a baseline population average of ~300g, demonstrating that the intervention itself, rather than specific behavioral change techniques (BCTs), drives the outcome.

As a primary care clinician, you do not need extensive training or long consultations to help patients with obesity lose weight. Simply delivering a brief, opportunistic piece of advice (around 1.5 minutes) at the end of a routine visit is sufficient to motivate patients to take action and achieve a modest but significant weight loss (approx. 1 kg) over a year. Focus on the act of advising rather than perfecting specific behavioral techniques.

The use of the Behavioral Change Technique 'Feedback on outcomes of behaviour (future)' significantly increases the likelihood of patients taking action to lose weight by 12 months (OR=6.10), although it does not directly correlate with greater mean weight loss.

When giving brief weight loss advice, explicitly schedule a follow-up appointment or promise to provide feedback on the patient's weight in the future. This specific technique ('Feedback on outcomes of behaviour (future)') makes patients significantly more likely to take action (e.g., diet/exercise changes) within a year, even if the total weight loss isn't drastically different from other methods.

Psychosocial factors (confidence, social support, emotional eating) and metabolic status are stronger predictors of weight loss success in behavioral obesity treatment than diet type (low-fat vs. low-carb) or demographic variables alone.

If you are starting a weight loss program, your success is less about whether you choose low-fat or low-carb and more about your mindset and environment. Assess your confidence in sticking to the plan, manage emotional eating, and ensure your social circle is supportive. If you struggle with emotional eating, seek specific psychological support alongside dietary changes.

Resistance training does not reduce flexibility; this is a common myth.

You do not need to fear that lifting weights will make you stiff. Resistance training, when performed through a full range of motion, does not reduce flexibility and can be part of a balanced fitness routine.

In overweight or obese adults with type 2 diabetes, intensive lifestyle intervention (ILI) eliminates the association between weight variability and increased risk of major adverse cardiovascular events (MACE), whereas without ILI, high weight variability significantly increases MACE risk.

If you have type 2 diabetes and are overweight, do not avoid weight loss because you are afraid of weight fluctuations. Engage in a structured, intensive lifestyle program (diet and exercise counseling). This paper shows that the weight changes resulting from such a program do not increase your risk of heart events, unlike unmanaged weight variability.

Higher Body Mass Index (BMI) causally reduces subjective wellbeing, specifically by lowering satisfaction with health.

If you are carrying excess weight, it is likely affecting your mental wellbeing, specifically your satisfaction with your health. This is not just 'in your head' but a causal effect. Addressing your BMI through lifestyle changes may improve your subjective wellbeing and health satisfaction.

Social support from family and friends is a significant factor in maternal exercise adherence, but often acts as a barrier due to negative or uninformed advice.

Your family's advice might be wrong. Many people discourage pregnant women from exercising due to outdated beliefs. If you are active, proactively share reliable information with your family to turn their potential discouragement into support.

A 16-week behavioral weight loss intervention produces equivalent clinically significant weight loss in high-obesity-prevalence regions (Alabama) and low-obesity-prevalence regions (Colorado), indicating that regional environmental factors are not primary barriers to individual weight loss success.

If you are struggling with weight loss in a region known for high obesity rates, do not assume your location makes success impossible. This study demonstrates that a structured 16-week behavioral program can yield significant weight loss (approx. 11%) regardless of whether you live in a high-obesity area like Alabama or a low-obesity area like Colorado. Focus on adherence to the program rather than blaming your environment.

Participants in high-obesity-prevalence regions (Alabama) demonstrate greater improvements in objective physical activity metrics (steps, stepping time, activity score) and favorable psychosocial factors (hedonic eating, social support) compared to those in low-obesity-prevalence regions (Colorado) during a behavioral weight loss intervention.

While weight loss amounts may be similar across regions, the behavioral journey differs. People in high-obesity regions may benefit from leveraging social support and managing hedonic eating triggers, as this study showed greater improvements in these areas for participants in Alabama. Building a strong support network is a key lever for success.

Prevention of weight regain through a predefined reoperation algorithm is critical for sustaining quality of life and comorbidity remission after bariatric surgery.

Sustaining weight loss is more important for long-term quality of life than the specific type of bariatric surgery chosen. Patients should engage with post-operative monitoring and be open to reoperation if weight regain occurs, as this is key to maintaining health improvements.

A 10-year multidomain intensive lifestyle intervention (ILI) targeting weight loss, physical activity, and diet in individuals with type 2 diabetes and obesity results in sustained long-term weight loss and lower deficit accumulation (frailty) compared to diabetes support and education (DSE), though it does not significantly improve composite cognitive function scores.

For older adults with type 2 diabetes, a structured lifestyle program focusing on diet, exercise, and regular monitoring can help maintain weight loss and reduce physical frailty over the long term, even if it doesn't necessarily improve cognitive function scores. The key is consistency and metabolic monitoring.

A high-carbohydrate diet (79% carbs) does not improve hedonic regulation (liking/wanting) of food intake compared to high-fat or control diets, though it may increase subjective satiety due to fiber content.

Eating a high-carbohydrate diet may make you feel more full due to fiber content, but it does not change your psychological desire (liking/wanting) for food compared to high-fat or balanced diets.

Performing resistance training to momentary muscular failure (FAIL) results in slightly greater perceived discomfort and exertion, and worsens general post-exercise feelings compared to terminating sets with 1-2 repetitions in reserve (RIR).

If you are struggling to stick to your resistance training routine because you hate how you feel after workouts, try stopping your sets 1-2 reps before you fail (1-2 RIR) instead of going to absolute failure. This study found that while muscle growth and strength gains are similar, training to failure significantly increases discomfort, exertion, and negative feelings. By using 1-2 RIR, you get the same physical benefits with better post-workout feelings, which may help you stay consistent long-term.

Higher doses of orforglipron (36-45 mg) are associated with increased treatment discontinuation due to adverse events compared to lower doses and placebo.

Higher doses of orforglipron work better for weight loss but cause more side effects, leading some people to stop taking it. If you struggle with side effects, ask your doctor about a lower dose (24-36 mg) which may be easier to tolerate.

Insomnia and insufficient sleep duration are independent cardiovascular risk factors that should be addressed alongside OSA.

If you have sleep apnea but also struggle with insomnia or don't get enough sleep, treating those issues is just as important for your heart as using your CPAP. Ask your doctor about Cognitive Behavioral Therapy for Insomnia (CBTi), which is the gold standard treatment for insomnia.

For patients with poorly controlled type 2 diabetes on basal insulin, using FreeStyle Libre (FSL) continuous glucose monitoring systems reduces overall lifetime healthcare costs and increases quality-adjusted life years (QALYs) compared to self-blood glucose monitoring (SBGM).

If you have type 2 diabetes, take basal insulin, and your blood sugar is not well controlled (HbA1c > 8%), switching from finger-prick testing to a flash glucose monitor (like FreeStyle Libre) is likely to save your healthcare system money and improve your long-term health and quality of life. This is because it helps prevent dangerous low blood sugar events and long-term complications like heart disease or kidney failure, while also being less painful and inconvenient than daily finger pricks.

Implementing enhanced nurse care manager (NCM) training and digital monitoring tools in primary care significantly increases patient enrollment in online behavioral weight loss programs compared to basic implementation, without compromising weight loss outcomes or program acceptability.

For primary care systems, simply offering an online weight loss program is not enough. You must invest in 'Enhanced' implementation strategies: train your care managers in motivational interviewing, provide them with a dashboard that flags non-adhering patients, and encourage proactive follow-up calls. This approach significantly increases the number of patients who start the program, which is the biggest hurdle in obesity treatment, even if it doesn't change the weight loss results for those who do start.