Browse the evidence

The Behavioral Change Technique 'Instruction on how to perform behaviour' is associated with weight GAIN (mean weight change +2.53 kg) rather than loss, suggesting it may be counterproductive in brief, opportunistic primary care advice.

Avoid using 'Instruction on how to perform behaviour' (like handing out leaflets or directing to websites) as a primary strategy in brief weight loss advice. This study found it was associated with weight gain, likely because it is used as a 'simple way to intervene' with patients who are less ready to change. Instead, focus on motivational feedback and follow-up.

Standard-of-care weight management in primary care is characterized by extremely low rates of active treatment, with only 12% of eligible patients receiving a weight-prioritized visit and less than 6% receiving any weight-related referral or anti-obesity drug prescription.

If you have a BMI over 25, do not assume your regular doctor is actively treating your weight. In standard practice, most patients like you are not getting referrals or medications. You must explicitly request a 'weight-prioritized visit' or ask for specific interventions (referrals, medications) to break through the system's inertia.

Food Frequency Questionnaires (FFQs) are error-prone for estimating fat intake, particularly for edible oils in Chinese populations, leading to potential inaccuracies in the PURE study's conclusions.

Be cautious when interpreting dietary studies that rely solely on self-reported food frequency questionnaires, especially for fat intake. For more accurate assessment, biomarkers like erythrocyte membrane fatty acids are superior.

Obesity is a chronic disease characterized by complex abnormalities in body weight regulation, and weight-related stigmatization is a key barrier to effective care.

Healthcare providers should treat obesity as a chronic disease, not a moral failing. Avoid stigmatizing language to build trust and encourage patients to seek and adhere to treatment.

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).

In real-world clinical practice, approximately half of patients initiating oral semaglutide for Type 2 Diabetes Mellitus remain on their initial treatment regimen without change for at least 6 months.

If you start oral semaglutide for Type 2 Diabetes, there is a roughly 50% chance you will stay on that exact treatment plan for the next six months without needing to switch or add other diabetes medications. This stability is a common and successful real-world outcome, not a sign that treatment is failing.

Stronger corporate nutrition-related commitments in the French food industry do not translate into better product portfolio healthiness or marketing practices.

Do not rely on a company's stated 'health goals' or 'commitments' as a proxy for product quality. The data shows these promises do not correlate with the actual nutritional content of their products. Focus on the product itself (e.g., Nutri-Score, ingredient list) rather than the company's public relations.

Increasing the price of meat, dairy, and oils/fats reduces saturated fat intake, but the demand is inelastic, meaning substantial price increases (e.g., 100% tax) are required to achieve modest reductions in intake.

If you are a policymaker, know that simply raising prices on fats will not drastically change diets because people are not very sensitive to price changes for these items. You would need extremely high taxes (doubling the price) to see any real drop in saturated fat intake, and even then, the drop is small. Focus on meat taxes in high-income countries where sensitivity is higher, but expect limited results overall.

Adherence to macronutrient-restricted diets (low-carb or low-fat) is often inadequate, with many participants failing to meet the specified macronutrient targets, and energy intake often not differing between restricted and ad libitum groups.

Don't stress if you can't hit exact macronutrient targets. Most people in clinical trials don't either. Focus on sustainable habits rather than perfect adherence to specific numbers.

Minoritized racial and ethnic groups in the US Veterans Affairs healthcare system receive significantly less access to evidence-based obesity treatments (medications and bariatric surgery) compared to White patients, despite having universal insurance coverage.

If you are a minority veteran with obesity, do not assume insurance alone guarantees access to the best treatments. Proactively ask your provider about all options, including medications and surgery, and advocate for yourself if you feel you are being steered only toward lifestyle programs.

Minoritized patients are disproportionately funneled into lifestyle counseling (MOVE!) while being underutilized for more effective, intensive treatments like medications and bariatric surgery.

Be aware that you might be offered lifestyle programs first. While these are helpful, they are less effective than medications or surgery for many. Ask your provider why you are not being considered for more intensive treatments if your BMI and health status warrant it.

A structured behavioral group intervention focusing on satiety and healthy eating habits ('Dare to feel full') does not produce superior long-term weight loss or metabolic improvements compared to a brief individual counseling session with standard dietary advice in overweight/obese adults.

For sustainable weight management, intensive group programs may not offer advantages over brief, personalized counseling. Focus on maintaining a healthy, varied diet and regular follow-up rather than seeking complex, time-intensive interventions.

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.

Mandatory structured lifestyle modification programs prior to metabolic surgery do not improve post-operative outcomes and may cause harm by delaying access to surgery.

If you are being told you must complete a mandatory weight loss program before surgery, understand that this is likely a bureaucratic or insurance barrier, not a medical necessity. The evidence shows these programs do not improve surgical outcomes and may delay life-saving treatment. Seek a second opinion from a surgeon who follows modern guidelines that do not mandate pre-surgical weight loss.

Communicating genetic risk information to patients does not significantly improve weight loss outcomes or adherence compared to standard advice alone.

Getting a genetic test for obesity or diabetes risk does not automatically help you lose weight or stick to a diet. Studies show that simply knowing your risk score does not improve outcomes compared to standard advice. Focus on evidence-based lifestyle changes (diet, exercise) rather than relying on genetic risk information as a motivator.

A low-intensity mobile health intervention (Few Touch Application) combined with or without health counseling does not significantly improve glycated hemoglobin (HbA1c) levels compared to usual care in patients with type 2 diabetes over a 4-month period.

Using a diabetes app or receiving brief phone counseling from a nurse does not guarantee better blood sugar control (HbA1c) than standard care alone in the short term. While these tools may improve self-management skills and confidence, patients should not rely on them as a substitute for comprehensive medical management and lifestyle changes.

Higher community population density and greater impervious surface area (urbanization metrics) are associated with significantly lower total physical activity levels in adults.

If you live in a dense urban area, be aware that your total daily movement is likely lower than in rural areas, even if you have access to gyms. To counteract this, you must intentionally incorporate active transport (walking/cycling) and avoid sedentary occupational habits, as urbanization naturally suppresses household and occupational activity.

A higher ratio of bars/pubs to liquor stores in one's local food environment is positively associated with an increased risk of obesity and abdominal obesity.

Living in an area with many bars and pubs relative to liquor stores increases your risk of obesity, particularly around the waist. This is likely due to the high-calorie food and alcohol served in these establishments. Be mindful of your local bar density and its potential impact on your health.

Family doctors are primarily involved in obesity management through diagnosis (BMI measurement) and trial recruitment, rather than active care delivery, nutrition counseling, or physical activity advice.

If you are seeing a family doctor for obesity, expect them to measure your height and weight. Do not assume they will provide detailed diet or exercise plans unless they are part of a specific research trial or a specialized clinic. You may need to seek out specific behavioral interventions or referrals separately.

There is a significant disconnect between the extensive role family doctors are expected to play in clinical guidelines and the limited role they actually play in current practice and intervention studies.

Be aware that family doctors may not be able to provide comprehensive obesity management due to systemic constraints. Advocate for yourself by asking for specific referrals to dietitians, exercise physiologists, or behavioral health specialists if your doctor's role is limited to diagnosis.