Browse the evidence

Intensive, multicomponent behavioral weight loss interventions produce statistically significant, albeit modest, weight loss (-2.4 kg) and reduce the incidence of type 2 diabetes in adults with overweight or obesity, without increasing serious adverse events.

Engage in a structured behavioral program focusing on diet and physical activity. While the average weight loss is modest (around 5 lbs), the program significantly lowers your risk of developing type 2 diabetes. Consistency over 12-36 months is key, and serious side effects are not a concern with this approach.

Digital health interventions are significantly more effective when they integrate behavioral theory, design thinking (user-centered design), and rigorous evaluation (RCTs) into a single iterative framework (IDEAS) rather than relying on any single approach in isolation.

If you are building a digital health tool, do not rely on tech features alone. Start by understanding your users' deep needs (empathize). Then, select specific, evidence-based behavior change techniques (like goal setting or feedback) to address those needs. Build rough prototypes early and test them with real users repeatedly before writing final code. Finally, test the finished product with a rigorous study (like an RCT) and share the results openly.

Very low carbohydrate diets (VLCDs) are less effective for weight loss than less restrictive LCDs, but this is explained by lower adherence rather than the diet itself.

If you try a very strict low carb diet (under 50g carbs/day) and find it too hard to maintain, you might lose less weight. This isn't because the diet doesn't work, but because it's harder to stick to. If you can't maintain the strict version, a less restrictive low carb diet (under 130g/day) is a viable alternative that still offers significant benefits for diabetes remission and weight loss.

Current physical activity guidelines exclude light-intensity activity because existing evidence relies on imprecise self-reports rather than objective data, not because light-intensity activity lacks health benefits.

Do not wait for moderate or vigorous exercise to start moving. Light-intensity activities (like standing or slow walking) are likely beneficial, even if current guidelines do not explicitly prescribe them. Focus on accumulating movement throughout the day.

Regular breakfast consumption is a common characteristic among individuals who successfully maintain long-term weight loss, though it is not strictly necessary for success.

If you are trying to maintain weight loss, consider eating breakfast regularly. While you don't have to if you don't want to, 78% of people who successfully keep weight off do eat breakfast every day. It might help you stay consistent with your diet and physical activity.

SMS-based interventions for lifestyle behavior change (diet, physical activity, smoking cessation) show mixed results, with some trials demonstrating significant improvements in smoking cessation and dietary quality, while others show no benefit for weight loss or physical activity.

Text message programs can be a helpful tool for quitting smoking or improving your diet, but they are less reliable for weight loss or increasing exercise on their own. Look for programs that send personalized messages and allow you to reply, rather than generic blasts. If you are trying to lose weight, combine SMS reminders with other strategies like in-person counseling or structured exercise programs.

Dietary modifications, specifically reducing meal size and avoiding high-fat or spicy foods, are effective non-pharmacological interventions for managing mild gastrointestinal side effects during GLP-1RA treatment.

To avoid stomach upset from GLP-1s, eat smaller portions, stop when you feel full, and avoid greasy or spicy foods, especially when starting. Drink plenty of water and increase fiber if you are constipated.

Living in neighborhoods with limited access to healthy food options (food deserts) and high density of fast food restaurants is associated with higher obesity rates and poorer diet quality, particularly in lower-income and minority communities.

Be aware that your environment influences your food choices. If you live in an area with limited access to healthy food, seek out community resources, farmers' markets, or online grocery delivery to improve access to nutritious options.

In modern environments, maintaining healthy body weight requires substantial conscious cognitive effort because biological instinctual mechanisms (which favor energy conservation and intake) are mismatched with abundant food and low physical activity demands.

Stop relying on your body to naturally regulate your weight in a modern world of abundant food and sedentary jobs. You must actively manage your energy balance through conscious choices: restrict food intake (especially fat/calories) and increase physical activity (e.g., aiming for ~10,000 steps/day). Without this deliberate cognitive effort, weight gain is the likely default outcome.

Environmental changes (food labeling, portion sizes, physical activity infrastructure) are necessary complements to individual cognitive effort to support healthy weight management.

Seek environments that support your goals: choose workplaces with walking opportunities, restaurants with clear calorie labeling, and communities with walkable infrastructure. Individual effort is harder without these supports.

Obesity prevalence in developed countries is strongly linked to secular declines in Lifestyle Physical Activity (LSPA/NEAT) due to environmental and technological factors, rather than solely a decrease in leisure-time physical activity (LTPA).

Recognize that modern environments are designed to minimize movement. To combat this, intentionally integrate more movement into daily tasks (LSPA), such as walking for errands, taking stairs, or standing while working, as these small accumulations significantly impact long-term energy balance.

The presence of an obese adult in a family significantly increases the prevalence of obesity in children, while decreasing the prevalence of malnutrition in children.

Family-based interventions are crucial. If an adult in a low-income household is obese, children are at high risk of obesity regardless of their own current nutritional status. Interventions should target the entire household's dietary patterns.

Higher consumption of energy-dense, nutrient-poor foods (candy, take-out, baked sweets) and lower consumption of nutrient-dense core foods (whole grains, breakfast cereals) are significantly associated with higher scores on the Yale Food Addiction Scale (YFAS), indicating addictive-like eating behaviors.

Focus on the quality of your diet, not just the quantity. If you find yourself struggling with cravings or loss of control over eating, look at the types of foods you are consuming. Diets high in candy, take-out, and baked sweets, and low in whole grains and core foods, are linked to higher levels of addictive-like eating behaviors. Try reducing these specific food categories and increasing whole-grain products and breakfast cereals to see if it helps manage these behaviors.

Weight loss interventions, including lifestyle changes and ACE inhibition, can reduce blood pressure, glomerular hyperfiltration, and proteinuria in obese patients with CKD.

If you have kidney disease and are overweight, losing weight can help your kidneys by lowering blood pressure and reducing protein leakage. Talk to your doctor about a safe weight loss plan, which may include diet changes, exercise, and medications like ACE inhibitors. In advanced kidney disease, the approach needs to be very careful to avoid malnutrition.

eHealth technologies (web programs, mobile apps, text messaging, wearables, VR/AR) support diabetes self-management behaviors (diet and physical activity) and improve glycemic control and lifestyle outcomes compared to usual care.

Use eHealth tools like apps, text messages, or wearables to help manage your diet and activity. They work best when they give you personalized feedback and reminders. Don't rely on them alone; use them to support your regular doctor visits. If you find the technology hard to use, ask for help or choose a simpler tool.

Wearable technologies, specifically pedometers, increase physical activity levels in people with Type 2 Diabetes, but this increase does not necessarily translate to improved HbA1c levels.

Wearing a pedometer will likely help you walk more. However, just walking more might not be enough to lower your blood sugar (HbA1c). You should combine this with other diabetes management strategies like diet control.

Long-term weight loss maintenance is associated with consuming a diet with limited variety across all food groups, particularly high-fat-dense groups, which helps sustain lower energy intake.

To maintain weight loss, consider limiting the variety of foods you eat, especially high-fat items. Successful maintainers often eat a narrower range of foods, which simplifies their diet and helps control energy intake. Focus on variety within low-fat groups (like vegetables) but restrict variety in high-fat groups (like sweets and fried foods).

Primary care physicians overwhelmingly support integrating nutrition counseling training and practice-based tools (such as BMI reporting on scales and in charts) to improve obesity care, with nutritionists/dietitians identified as the most qualified providers for weight management.

Healthcare systems should equip primary care physicians with automated BMI reporting tools and integrate nutritionists or dietitians into the care team. Physicians should receive specific training in nutrition counseling to effectively support patients in weight management.

Longer duration of weight loss maintenance is associated with a significant decrease in the perceived effort and attention required to maintain weight, while the pleasure derived from maintenance behaviors remains constant, resulting in a more favorable effort-to-pleasure ratio.

If you are struggling with the mental load of dieting, recognize that this is likely a phase. The data suggests that as you maintain your weight loss for years, the behaviors become habitual and require less conscious effort. Do not interpret current high effort as a sign that you are failing; it is a sign that you are in the transition to automaticity. Focus on consistency to allow the habit to form.

Interventions that deplete glycogen stores, such as intermittent fasting, caloric restriction, and exercise, promote health by inducing moderate hormetic oxidative stress.

Regular exercise, fasting, or caloric restriction deplete glycogen, which triggers a healthy stress response (hormesis) that improves long-term health and longevity.

A Food Frequency Questionnaire (FFQ) provides a valid estimate of total energy intake relative to doubly-labeled water measurements in free-living populations, whereas 24-hour recalls are prone to significant underreporting, particularly in women and heavy alcohol consumers.

If you are tracking your diet to manage weight, be aware that 24-hour recalls often underestimate how much you eat, especially if you drink alcohol or are a woman. A Food Frequency Questionnaire (FFQ) may provide a more accurate picture of your total energy intake relative to your actual energy expenditure. Do not rely solely on daily food logs if you suspect you are underreporting.

A validated physical activity questionnaire (Kriska questionnaire) significantly correlates with objective energy expenditure (TEE/BMR) in Pima Indians, indicating that self-reported leisure and occupational activity is a reliable proxy for metabolic cost in this population.

For populations with high obesity and diabetes risk, self-reported physical activity questionnaires can be a valid tool to estimate energy expenditure. This allows for better assessment of lifestyle factors without requiring expensive doubly-labeled water tests in large-scale studies.

Eating rate is a primary driver of increased calorie intake, and slowing consumption through product reformulation represents a viable public health intervention to reduce energy intake.

To reduce calorie intake without changing what you eat, focus on slowing down your eating speed. The paper identifies eating rate as a direct driver of calorie consumption. You can leverage this by reformulating your food environment (e.g., choosing foods that require more chewing or are harder to eat quickly) or simply by consciously eating slower to allow satiety signals to register.

Early physical therapy, ambulation, and neuromuscular electrical stimulation (NMES) are potent stimuli that sensitize skeletal muscle to amino acids, helping to retain muscle mass in older ICU patients.

Start moving as soon as medically possible. This includes sitting up, walking, or using electrical stimulation if walking isn't possible. Movement makes your muscles more responsive to the protein you eat, helping to preserve strength and shorten your hospital stay.