Browse the evidence

The updated CG189 NICE guidelines recommend self-measurement of waist-to-height ratio (target ≥0.5) for adults with BMI <35 kg/m2 to assess abdominal fat and health risk, shifting focus from BMI alone.

If your BMI is under 35, measure your waist and divide it by your height. If the number is 0.5 or higher, you have increased health risk from abdominal fat. Share this number with your doctor to discuss next steps, rather than relying on BMI alone.

Societal stigma surrounding obesity negatively impacts psychological, physical, and socioeconomic health, and hinders engagement with obesity services.

Recognize that societal stigma is a major barrier to your health. Healthcare providers are encouraged to approach these topics sensitively and with your permission. You deserve compassionate care regardless of your weight.

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 physically active before and during early pregnancy, you are highly likely to maintain that activity level through the third trimester. Focus on establishing a consistent activity routine early on, as this habit is the strongest predictor of staying active later in pregnancy, more so than your weight or job status.

Among patients who actively participate in telephone health coaching (per-protocol analysis), the intervention significantly reduces the risk of renal insufficiency and composite cardiovascular events.

If you choose to try phone coaching for heart or diabetes issues, your active participation is crucial. The study found that those who actually engaged with the coaches saw significant reductions in kidney problems and heart events. If you drop out or don't engage, you likely won't see these benefits.

An intensive lifestyle intervention (diet and exercise) reduces major cardiovascular events in middle-aged women with poorly controlled diabetes and poor subjective health, but shows no benefit for middle-aged/older men with well-controlled diabetes and excellent health.

If you have type 2 diabetes and are overweight, standard lifestyle advice may not reduce your heart disease risk equally. If you are a middle-aged woman with poorly controlled diabetes and feel your general health is poor, an intensive lifestyle program focusing on weight loss and exercise is likely to help prevent heart events. However, if you are a man with well-controlled diabetes and feel you are in excellent health, this specific intensive intervention may not provide cardiovascular benefits. Consult your doctor to see if your specific profile matches the subgroup that benefits.

Patients who transfer hospitals for secondary MBS are significantly younger, have fewer obesity-related comorbidities (hypertension, GERD), and are more likely to undergo secondary surgery for recurrent weight gain compared to those who stay.

If you are younger and generally healthy but are experiencing weight regain after your first bariatric surgery, you are part of a common group that seeks a second opinion or a different surgeon for revisional surgery. This is often driven by dissatisfaction with the amount of weight lost rather than medical complications.

An intensive lifestyle intervention (diet and exercise) reduces major cardiovascular events in middle-aged women with poorly controlled diabetes and poor subjective health, but shows no benefit for middle-aged/older men with well-controlled diabetes and excellent health.

If you are a middle-aged woman with type 2 diabetes that is not well-controlled and you feel your general health is poor, an intensive lifestyle program focusing on weight loss and exercise is likely to reduce your risk of heart events. However, if you are a man with well-controlled diabetes and feel healthy, this specific intensive approach may not offer cardiovascular protection. Consult your doctor to see if your specific profile matches the 'benefiting' subgroup.

Increasing cardiorespiratory fitness (CRF) reduces morbidity and mortality regardless of changes in body weight or BMI, whereas intentional weight loss in healthy overweight/obese individuals does not improve and may increase mortality risk.

Stop focusing on weight loss as the primary health goal. Instead, aim for 150 minutes of moderate-intensity physical activity per week (like brisk walking or cycling). This level of activity significantly reduces your risk of death and heart disease, regardless of whether you lose weight. Prioritize feeling stronger and more energetic over the number on the scale.

Weight management interventions delivered by non-medical practitioners (e.g., health coaches) are as effective as those delivered by general practitioners (GPs) or nurses.

You don't need to see a doctor for every weight management visit. Programs led by health coaches or nurses, especially when supervised by a doctor, are just as effective. Focus on finding a program with good support and regular contact.

Referral to largely unsupported online weight loss programmes (NHS Weight Loss Plan, Rosemary Online, Slimming World Online) yields modest, statistically significant weight loss compared to no intervention only for Rosemary Online, while other programmes show no significant difference, indicating that digital interventions without substantial personal support are marginally superior to no intervention.

If you are considering an online weight loss program, look for one that offers some level of personal support or coaching, even if minimal. This study found that Rosemary Online, which included a proactive contact from a coach, resulted in significant weight loss compared to no intervention, whereas programs with no support (NHS Weight Loss Plan) or only chat support (Slimming World) did not show significant mean weight loss differences. Simply having access to a digital tool is not enough; engagement and support are key.

Short-term GPS-enabled physical activity interventions (≤3 months) produce greater weight loss effects than longer-term interventions (≥6 months).

If you start a fitness tracking program, expect the biggest results in the first 3 months. To maintain weight loss after that, you must actively work to keep the habit, as the 'newness' of the app will wear off. Consider switching to a less intrusive tracking method or adding social accountability to sustain engagement beyond the initial quarter.

A semiquantitative food frequency questionnaire (FFQ) provides valid and reproducible estimates of individual nutrient intakes over a one-year period, making it suitable for large-scale epidemiological studies of chronic disease.

For large population studies, a simple food frequency questionnaire is a valid tool to estimate long-term nutrient intake. It may not capture exact daily amounts, but it reliably ranks people by their typical intake, which is sufficient for identifying dietary risk factors for chronic diseases like heart disease and cancer.

Transitioning to emerging adulthood (ages 18-25) and enrolling in college is associated with significant adverse changes in weight-related behaviors, including increased obesity prevalence, decreased physical activity, and poorer diet quality.

If you are 18-25 and starting college or independent living, recognize this as a high-risk window for weight gain. Your environment (dining halls, marketing, stress) will likely push you toward poorer habits. Proactively establish routines for sleep, activity, and food choices now, as these patterns tend to track into adulthood.

College enrollment, particularly the first semester, is associated with significant weight gain (average 1.5-6.8 lbs) and decreased physical activity, with effects often maintained over 4 years.

Be aware that your first semester of college is a critical time for weight gain. Limit exposure to 'all-you-can-eat' dining halls and high-fat snacks. Prioritize physical activity even if your schedule is tight, as this gain tends to persist through graduation.

Self-administered semi-quantitative food frequency questionnaires (FFQs) provide valid and reproducible estimates of long-term intake for frequently consumed foods (e.g., dairy, beverages), but significantly overestimate socially desirable foods (fruits/vegetables) and underestimate less desirable foods (animal products) due to social desirability bias.

Use food frequency questionnaires to compare relative dietary patterns between individuals, but do not rely on them for precise absolute intake estimates of specific foods. Be aware that users will likely over-report fruits and vegetables and under-report meats and fats due to social desirability bias.

Mouth rinsing with a carbohydrate solution for 5-10 seconds during high-intensity exercise lasting 45-75 minutes enhances performance by 2-3% via central nervous system effects, independent of metabolic absorption.

If you are doing a hard effort like a 1-mile run or a 45-minute high-intensity interval session, swish a sports drink in your mouth for 5-10 seconds and spit it out. This tricks your brain into feeling like you are fueling, which can boost your performance by a few percent without upsetting your stomach.

Population-level economic incentives, specifically subsidies for healthful foods and taxes on less healthful foods/beverages, are effective strategies to improve dietary habits.

Support or advocate for local policies that subsidize fresh produce and impose taxes on sugary drinks or high-fat processed foods. These economic levers are among the most evidence-based ways to shift population diet quality.

Media and educational campaigns, particularly when sustained and focused on specific healthful foods, effectively increase consumption of those foods.

Look for or support community health campaigns that use multiple channels (TV, radio, in-store) to promote specific healthy foods. These are proven to increase consumption.

Self-reported dietary intake in obese women significantly underestimates actual energy expenditure, whereas lean women's self-reports are accurate.

Do not trust your own estimate of how much you eat if you are obese. This study shows obese women under-report their intake by nearly 850 calories per day compared to lean women, whose reports are accurate. To manage weight, rely on objective tracking methods or professional assessment rather than self-estimation.

Accelerometers provide objective, feasible measurements of physical activity and sedentary behavior in large-scale epidemiological studies, overcoming the limitations of self-report.

For researchers, accelerometers are a viable tool for collecting objective physical activity data in large cohorts. For individuals, wearing these devices can provide accurate insights into their daily movement patterns.

Age-related declines in taste and smell acuity reduce dietary variety and palatability, which contributes to reduced energy intake and impaired energy regulation in older adults.

Enhance the flavor, smell, and variety of your meals. Since your senses may be duller, use spices, herbs, and diverse textures to make food appealing, which can help stimulate the cephalic phase of digestion and encourage adequate intake.

Urban residence is associated with higher prevalence of overweight, obesity, and abdominal obesity compared to rural residence in both men and women.

If you live in an urban area, be mindful of the higher risk of obesity. Urban environments often promote Western-style diets and lower physical activity. Focus on whole foods and finding opportunities for physical activity to counteract these environmental factors.

High levels of sedentary behavior, specifically television watching, independently predict adverse cardiovascular biomarkers (lower HDL, higher LDL, higher leptin) regardless of the individual's level of physical activity.

Treat television watching as a distinct health risk factor separate from your exercise routine. Even if you are physically active, high hours of TV watching are linked to worse cholesterol and leptin levels. To optimize your cardiovascular biomarkers, you should aim to minimize sedentary screen time in addition to maintaining your physical activity.

Moderate alcohol consumption (1-2 drinks per day) is associated with a reduced risk of myocardial infarction and total mortality in men, but increases the risk of breast cancer in women.

Moderate alcohol consumption (1-2 drinks per day) may reduce heart disease risk in men, but increases breast cancer risk in women. The decision to drink should be based on individual health profiles and gender-specific risks.