Browse the evidence

The rapid increase in global obesity prevalence is primarily driven by environmental factors—specifically the high availability of energy-dense foods and increasingly sedentary lifestyles—rather than changes in the human gene pool.

Focus on your environment, not just your genetics. The rise in obesity is driven by easy access to high-calorie foods and less physical movement. To manage weight, prioritize reducing the availability of energy-dense foods in your home and increase daily physical activity, as these environmental factors are the primary drivers of weight gain regardless of your genetic background.

Chronic treatment with GDF15 promotes greater weight loss and reduces NAFLD compared to caloric restriction alone by maintaining energy expenditure and preventing adaptive thermogenesis in skeletal muscle.

This research suggests that GDF15 therapy could help overcome the metabolic slowdown (adaptive thermogenesis) that typically halts weight loss during dieting. By maintaining energy expenditure, particularly through fatty acid oxidation in muscle, GDF15 allows for greater fat loss than dieting alone. This is relevant for individuals who hit weight loss plateaus despite strict caloric restriction.

GDF15 maintains energy expenditure and promotes weight loss through a GFRAL-dependent signaling axis that activates beta-adrenergic receptors in skeletal muscle, increasing fatty acid oxidation and calcium futile cycling.

The weight loss benefits of GDF15 rely on a specific biological pathway involving the GFRAL receptor and beta-adrenergic signaling in muscles. If this pathway is blocked or missing, the energy expenditure benefits are lost.

Fructose-containing sugars do not exhibit unique metabolic or endocrine harms causing obesity or cardiometabolic disease when consumed in isocaloric substitution for other digestible carbohydrates; any adverse effects are mediated solely by excess caloric intake.

You do not need to fear fructose or added sugars if you are consuming them within your daily calorie needs and replacing other carbohydrates. Isocaloric substitution of fructose for other carbs does not worsen cardiometabolic risk factors like blood pressure, lipids, or insulin sensitivity. Focus on total energy balance and overall dietary quality rather than demonizing specific sugars.

The algebraic definition of Energy Availability (EA) has evolved to improve accuracy, with the current standard calculating EA relative to Lean Body Mass (LBM) rather than Total Body Mass (BM), subtracting non-exercise energy expenditure from gross exercise expenditure.

Use the current EA formula: (Energy Intake - Exercise Energy Expenditure) / Lean Body Mass. This is more accurate than using total body weight or gross exercise expenditure.

Higher body mass index (BMI), body weight, and waist circumference are inversely associated with cardiorespiratory fitness (CRF).

If you have a higher body weight or BMI, you may find your cardiorespiratory fitness (VO2max) is lower. This is a common physiological relationship. Addressing body weight through diet and activity can significantly improve your fitness levels, which in turn reduces your risk for chronic diseases.

The exact energy cost of skeletal muscle hypertrophy is unknown, and common textbook estimates based solely on tissue composition are likely inaccurate because they ignore the metabolic costs of synthesis, exercise, and adaptive thermogenesis.

Do not rely on textbook calculations for the exact energy cost of muscle gain. These estimates are likely inaccurate. Instead, use a conservative surplus (1,500-2,000 kJ/day) and adjust based on your progress. Individual responses vary greatly due to genetics and metabolic adaptations.

Bariatric/metabolic surgery (BMS) is the most effective strategy for significant and sustained body weight reduction (14-25%) and reduces the risk of hypertension, diabetes, and mortality, but remains underused.

For extreme obesity (BMI ≥ 40 or ≥ 35 with comorbidities), bariatric surgery is the most effective treatment, producing 14-25% weight loss and significantly reducing the risk of heart disease, diabetes, and death. Despite its effectiveness, it is underused. If lifestyle and medication fail, discuss surgery with your doctor as a viable, life-saving option.

Bariatric surgery is currently the most effective treatment for obesity in terms of mortality reduction and comorbidity resolution, but it is restricted to higher BMI classes and not suitable for all patients.

Bariatric surgery is the most effective treatment for obesity, significantly reducing mortality and type 2 diabetes risk, but it is generally reserved for patients with Class II or III obesity (BMI ≥ 35 or ≥ 40) and is not suitable for everyone due to surgical risks and access issues.

There is no significant interaction between FTO genetic variants and dietary intake (total energy, protein, carbohydrate, or fat) on Body Mass Index (BMI).

Having the FTO obesity gene does not mean you need a special diet. This study shows that whether you eat high or low carb, high or low fat, your BMI response to these diets is not significantly different from non-carriers. Focus on sustainable, balanced eating rather than trying to match a specific macronutrient profile to your genetics.

Metabolic and bariatric surgery (MBS) is the most effective treatment for obesity and type 2 diabetes, producing superior long-term weight loss and remission rates compared to lifestyle or pharmacologic interventions.

If you have severe obesity or type 2 diabetes, consider metabolic surgery. It is the most effective treatment for long-term weight loss and diabetes remission, far surpassing lifestyle changes or medications alone.

The prevalence of obesity among primary care patients increased from 39.2% in 2017 to 40.7% in 2019.

Healthcare providers should be aware of the rising obesity rates among their patients.

Aerobic exercise at 8 KKW did not induce weight change, and there was no significant change in any component of energy expenditure.

Lower intensity aerobic exercise may not be sufficient for weight loss or changes in energy expenditure.

No significant between-group differences were noted in any outcome measure.

Fasted and fed aerobic exercise yield similar results in body composition changes.

Nonalcoholic fatty liver disease (NAFLD) affects more than 25% of adults worldwide.

Healthcare providers should be aware of the high prevalence of NAFLD in adult populations.

The majority of patients with NAFLD are unaware of their condition.

Awareness and screening for NAFLD should be prioritized in clinical practice.

In patients with diabetes, there is no evidence of reduced all-cause mortality.

Practitioners should be aware that lifestyle interventions may not reduce mortality in patients already diagnosed with type 2 diabetes.

Insufficient evidence exists to suggest benefit on cardiovascular and microvascular outcomes in patients with diabetes.

Practitioners should consider that lifestyle interventions may not significantly impact cardiovascular or microvascular health in diabetic patients.

From 2015 to 2019, the percentage of T2D patients treated with a GLP-1 RA increased from 3.2% to 10.7%.

Healthcare providers should be aware of the increasing adoption of GLP-1 RAs among T2D patients.

Lower rates of GLP-1 RA use were found among Asian, Black, and Hispanic patients with T2D.

Efforts should be made to address the disparities in GLP-1 RA access among racial and ethnic minorities.

There is no consensus definition of sarcopenia despite its evolving criteria.

Practitioners should be aware of the lack of consensus in defining sarcopenia when diagnosing and treating patients.

Overall relative search volume (RSV) for 'Ozempic' grew exponentially in the United States between March 2018 and February 2023.

Practitioners should be aware of the increasing public interest in Ozempic for weight loss.

Statistically significant differences in search popularity were found between 'Ozempic', 'Wegovy', and 'Mounjaro' from December 2021 to February 2023.

Surgeons should consider the varying popularity of these medications in their practice.

Fifty-two articles corresponding to five registries were included in the review.

This indicates a comprehensive analysis of existing data on weight loss maintenance.