Browse the evidence

There is a significant disparity in medication initiation rates between diabetes and obesity indications, with 72.2% of diabetes prescriptions filled within 60 days compared to only 46.8% of obesity prescriptions.

If you are prescribed a GLP-1 for weight loss, be aware that you are less likely to fill the prescription than someone prescribed for diabetes. This is due to insurance coverage gaps, not a lack of desire to treat. Check your coverage status before the prescription is written to avoid delays.

High out-of-pocket costs for semaglutide create a socioeconomic barrier to access, resulting in significantly lower prescription rates among low-income individuals despite them having a higher prevalence of obesity.

If you are on a limited budget, the high out-of-pocket cost of semaglutide may prevent you from accessing it, even if you have obesity. This is a systemic issue where low-income individuals are undertreated. Advocacy for reimbursement or subsidies is needed to address this inequality.

Significant inequities exist in access to bariatric surgery in Australia, with lower rates in public hospitals, rural areas, and among males, despite similar or higher obesity prevalence in these groups.

Access to bariatric surgery in Australia is uneven, with rural residents, men, and those without private healthcare facing significant barriers. If you live in a rural area or are a man, be proactive in seeking information and support to overcome these barriers. Explore public sector options and discuss your specific situation with a healthcare provider.

Diet and lifestyle interventions alone are insufficient for long-term obesity management, as they typically result in only ~3% sustained weight loss at 5 years and fail to reverse population-level obesity trends.

Do not rely on short-term diet and exercise programs for long-term weight control. The average outcome is minimal sustained loss (~3%). Recognize obesity as a chronic condition requiring long-term, multidisciplinary support (medical, behavioral, environmental) rather than a finite 'program' you complete.

Positive Airway Pressure (PAP) therapy, while effective for reducing AHI and improving symptoms, has not demonstrated a benefit on composite cardiovascular endpoints in randomized controlled trials.

PAP is the standard treatment for OSA and effectively reduces breathing interruptions and daytime sleepiness. However, it does not appear to reduce long-term cardiovascular risks like heart attacks or strokes in large studies, and many patients struggle with adherence due to discomfort. It remains a good option for symptomatic relief and blood pressure control, but may not be a 'one-size-fits-all' solution.

Obesity lacks standardized diagnostic criteria and treatment targets compared to T2DM, leading to inconsistent care, underdiagnosis, and undertreatment.

If your doctor only uses BMI to diagnose obesity, ask for a more comprehensive assessment. This should include metabolic markers (blood pressure, lipids, glucose) and possibly the Edmonton Obesity Staging System to determine the severity of your condition and the appropriate treatment.

For individuals with obesity and prediabetes who fail to achieve early weight loss (<2.5% at 4 weeks), adding exercise counseling or time-restricted eating (TRE) counseling does not significantly improve weight loss or glycemic outcomes compared to continuing the initial diet alone.

If you are not losing weight in the first month of a diet, simply adding more exercise counseling or trying a new eating window might not be enough. You may need more intensive support, such as provided meals or supervised exercise, rather than just advice.

High cost or insurance-related barriers are the primary drivers of discontinuation for obesity pharmacotherapy with semaglutide or tirzepatide in clinical practice, accounting for nearly half of all early and late discontinuations.

If you are stopping semaglutide or tirzepatide, the most likely reason is cost or insurance issues, not that the drug didn't work. Check your insurance coverage, look for manufacturer coupons, and talk to your doctor about financial assistance programs before assuming the treatment is unsuitable for you.

Individuals with greater personal success in weight loss without medication exhibit higher obesity stigma and less favorable attitudes toward anti-obesity medications.

Healthcare providers should recognize that patients who have successfully lost weight through diet and exercise may be skeptical of or stigmatizing toward GLP-1 medications. Counseling should validate their success while explaining that biological factors can persist despite lifestyle efforts, making medication a valid and effective tool for others.

Male sex, older age (≥65 years), lower socioeconomic status (lower income, less education, higher area deprivation), and lack of insurance are associated with significantly lower odds of receiving anti-obesity medication (AOM) prescriptions and metabolic and bariatric surgery (MBS).

If you are male, older, or have limited income/insurance, you face significant systemic barriers to accessing obesity treatments like GLP-1s or surgery. This is not a reflection of your medical need but of socio-economic disparities. Seek providers who are aware of these disparities and advocate for coverage options or financial assistance programs.

Using percent body weight loss as the sole target for obesity management is not ideal because it is often not feasible or sustainable for most participants and fails to capture holistic health outcomes.

Stop fixating on a specific percentage of weight loss as the only measure of success. For many people, achieving even a modest weight loss is not sustainable. Instead, focus on patient-centered outcomes like improved blood pressure, better glycemic control, and increased quality of life, which can be achieved through various lifestyle changes regardless of the final number on the scale.

Weekly injectable semaglutide demonstrates very low persistence in real-world Colombian patients, with a mean duration of use of only 93.7 days and less than 1% persistence at 12 months.

If you are starting weekly injectable semaglutide, be aware that persistence is very low in real-world settings. Most people stop within 3 months. To stay on the medication, ensure you have good access, receive proper education on how to inject, and have regular follow-up with your doctor to manage tolerability.

Access to effective obesity pharmacotherapy is severely limited by cost, insurance prior authorization, and systemic inequities, leading to high discontinuation rates.

Even if your doctor prescribes a weight loss drug, insurance may not cover it, or it may be too expensive. You might face delays due to prior authorizations. Ask your doctor about manufacturer assistance programs or alternative coverage options.

Existing patient-reported outcome (PRO) measures inadequately capture the full spectrum of emotional impacts of obesity and weight loss, specifically missing concepts such as feeling happy, energetic, proud, or joyful, as well as negative emotions like grief, disappointment, or skepticism.

If you are tracking the success of your weight loss journey, standard health surveys might not reflect how you truly feel. This research suggests that specific emotional changes—like feeling more energetic, confident, or joyful—are real and significant benefits of treatment, but they are often missed by standard medical questionnaires. To get a complete picture of your progress, use or advocate for tools specifically designed to measure emotional well-being in the context of weight, such as the Weight and Emotions Scale (WES).

Standardized multidisciplinary care and ERAS protocols reduce postoperative complications to ~1% and shorten hospital stays, improving overall safety and long-term outcomes.

Choosing a bariatric center that uses standardized protocols and multidisciplinary teams (surgeons, endocrinologists, psychologists) significantly lowers the risk of complications and shortens recovery time, leading to safer and more sustainable results.

Using GLP-1 receptor agonists for weight loss results in higher social stigma and lower willingness to affiliate compared to losing weight through diet and exercise, and is stigmatized even more than remaining at a higher weight without attempting weight loss.

If you use GLP-1s for weight loss, be aware that you may face significant social judgment, potentially more than if you stayed at your current weight. This stigma stems from perceptions that medication is an 'easy shortcut' compared to diet and exercise. This social penalty can undermine the psychological benefits of weight loss and may discourage continued treatment. It is important to seek support and understand that this stigma is a social bias, not a reflection of your health efforts.

Regaining weight after discontinuing GLP-1 receptor agonists is stigmatized to a similar degree as regaining weight after discontinuing diet and exercise, and both are stigmatized more than maintaining weight loss.

If you regain weight after stopping GLP-1s, you may face social judgment similar to that faced by those who regain weight after dieting. This stigma is not unique to medication users. Recognize that weight regain is a common outcome and does not reflect a lack of character. Focus on sustainable health practices rather than avoiding social judgment.

Existing patient-reported outcome (PRO) measures for obesity fail to capture key appetite and eating behavior concepts (e.g., duration of fullness, satisfaction after eating, eating between meals) that are relevant to individuals with obesity and likely to change with treatment.

If you are managing obesity, standard questionnaires might miss how you actually feel after eating (satisfaction, fullness duration). This gap means your provider might not fully understand your specific challenges with cravings or portion control. A comprehensive assessment tool (like the EBAQ) can better capture these nuances to tailor your treatment plan.

Approximately 11.5% of patients undergoing secondary metabolic bariatric surgery (MBS) transfer to a different hospital than their primary procedure, a rate that is underestimated in single-institution registries.

If you are considering secondary bariatric surgery, be aware that about 11% of patients switch hospitals for this procedure. This is often driven by dissatisfaction with weight regain or complications from the first surgery. You are not alone in seeking a second opinion or a different provider if you feel your current care is not meeting your expectations.

Body weight stigma acts as a significant barrier to healthcare engagement and long-term weight management success.

If you feel judged by healthcare providers, it is a common and valid experience that can hinder your care. Seek out providers who practice weight-inclusive or stigma-informed care. Addressing the psychological burden of stigma is a crucial part of effective obesity management.

Current herbal anti-obesity clinical trials frequently fail to adhere to international pharmaceutical guidelines, particularly regarding study duration, lifestyle modifications, and safety monitoring.

When evaluating herbal weight loss studies, be aware that many do not follow the same rigorous standards as pharmaceutical trials. Look for studies that include lifestyle modifications, adequate duration, and safety monitoring, as these are often missing.

Off-label use of GLP-1 agonists by healthy athletes for aesthetic or performance purposes raises ethical, legal, and safety concerns, including potential classification as doping and inequality in sports access.

Using GLP-1 agonists off-label for aesthetic or performance reasons is not approved and carries ethical and legal risks. It may be viewed as doping and creates inequality in sports. Athletes should consult regulatory bodies and prioritize approved medical indications over off-label use for performance enhancement.

Public awareness of the clinical success of anti-obesity medications (AOMs) does not reduce obesity stigma or shift public perception of obesity from a failure of willpower to a biological medical condition.

Health communicators and policymakers should not assume that highlighting the success of GLP-1 medications will automatically reduce obesity stigma. Since stigma is robustly linked to personal weight loss experiences and willpower beliefs, interventions must directly address these cognitive biases rather than relying on medical awareness alone.

AI-powered virtual health coaches (e.g., chatbots like Paola) combined with wearables can significantly improve physical activity, dietary adherence, and reduce weight and waist circumference in inactive adults aged 45-75.

For adults over 45 who are inactive, using an AI-powered health app with a wearable tracker can significantly boost physical activity and improve diet. Look for programs that offer a chatbot for guidance and track your activity automatically. This approach can lead to modest but meaningful weight loss and waist reduction without needing intensive in-person counseling.