Browse the evidence

Bariatric surgery in Saudi Arabia achieves an average weight loss of 18% (33.6 kg) at 6 months, with high rates of sleeve gastrectomy and a young patient demographic.

Bariatric surgery in Saudi Arabia is highly effective, with an average 18% body weight loss at 6 months. It is predominantly performed on young women via sleeve gastrectomy.

An 8-week very low carbohydrate ketogenic diet significantly improves metabolic health markers (lipids, glucose, insulin, inflammation) in competitive natural bodybuilders compared to a Western diet.

Beyond body composition, this diet significantly improves metabolic health markers. You will see lower triglycerides, better insulin sensitivity, and reduced inflammation. This makes it a viable option for bodybuilders concerned with long-term health metrics during a cut.

Successful weight loss maintainers and normal-weight individuals engage in significantly more light-intensity physical activity (LPA) and spend less time in sedentary behavior (SB) compared to individuals with overweight/obesity.

In addition to structured exercise, try to increase your daily light activity (like standing, slow walking, or household chores) and reduce long periods of sitting. Breaking up sedentary time with standing or light movement can help support your weight management efforts.

Phenotype-tailored interventions improve specific cardiometabolic risk factors, including waist circumference and triglycerides, more effectively than standard lifestyle interventions.

Focus on reducing waist circumference and triglycerides by adhering to a phenotype-tailored plan that ensures a consistent caloric deficit and appropriate physical activity, as this approach has been shown to improve these specific risk factors more than standard advice.

Phenotype-tailored interventions preserve lean mass percentage and resting energy expenditure (REE) better than standard lifestyle interventions.

To maintain muscle and metabolic rate during weight loss, follow a phenotype-tailored plan that includes specific exercise (like HIIT for low REE) and protein timing, as these strategies help preserve lean mass better than standard advice.

Omega-3 polyunsaturated fatty acids (n-3 PUFA), specifically EPA and DHA, can reduce body fat mass and abdominal adiposity, but may not significantly reduce total body weight in overweight or obese individuals when used as a supplement alone.

Omega-3 supplements (EPA/DHA) may help reduce body fat, especially abdominal fat, but are unlikely to cause significant total weight loss on their own. They are most effective when combined with calorie restriction and exercise.

Highly processed, palatable, and cheap foods (high in sugar, fat, salt, and flavor additives) trigger overconsumption of calories by shifting eating behaviors from home cooking to snacking and large-portion meals.

Prioritize whole, unprocessed foods over highly processed options. Be aware that processed foods with added sugar, fat, and salt are engineered to promote overconsumption, making portion control difficult.

The reduction in occupational physical activity, rather than a lack of formal exercise, is a major contributor to the obesity epidemic, creating a zone of low energy expenditure where intake becomes uncoupled from expenditure.

Incorporate movement into your workday. If your job is sedentary, try to stand, walk, or move frequently during the day, as this has a larger impact on daily energy expenditure than formal exercise alone.

Transdermal TRT improves metabolic markers, including resting energy expenditure (REE) and HDL cholesterol, in men with spinal cord injury, potentially reducing cardiovascular disease risk.

Testosterone therapy can help boost your metabolism and improve your 'good' cholesterol (HDL) levels, which is beneficial for heart health. This happens partly because building muscle increases your resting energy expenditure. While this doesn't replace the need for a healthy diet, it provides a metabolic advantage that can help manage weight and cardiovascular risk over time.

Increasing dietary fiber (e.g., polydextrose, inulin, beta-glucan) in reformulated pastries increases satiety and reduces energy density, aiding in weight management.

Choose pastries and baked goods that list dietary fibers like inulin, beta-glucan, or polydextrose in their ingredients. These fibers help you feel fuller for longer and reduce the overall calories in the product, supporting your weight management goals.

Intermittent energy restriction (including alternate day fasting) produces weight loss similar to daily continuous energy restriction over 3-6 months, with no proven metabolic benefit beyond the weight loss itself.

If you prefer intermittent fasting, it will help you lose weight just as well as eating fewer calories every day. Don't expect it to be magically better for your health or metabolism; it's just a different way to eat less.

Targeting energy expenditure through thermogenic pathways (such as UCP1, futile creatine, calcium, or lipid cycles) is a viable therapeutic strategy for promoting negative energy balance and sustaining weight loss, distinct from appetite suppression.

While lifestyle changes are foundational, they often fail long-term due to biological counter-regulation. Future treatments may focus on boosting energy expenditure through specific cellular mechanisms (like thermogenesis in fat or muscle) rather than just restricting calories. For now, understanding that your body fights weight loss through increased hunger and reduced expenditure is key to managing expectations.

Among Japanese patients with type 2 diabetes, low intake of vegetables (specifically green-yellow and other vegetables) and high intake of sweets are the strongest dietary predictors of obesity, with these associations holding true across both men and women.

For Japanese patients with Type 2 Diabetes, managing obesity relies less on counting total calories and more on food quality. Prioritize increasing intake of green-yellow and other vegetables, as low vegetable intake is a strong predictor of obesity. Simultaneously, reduce sweets. If you consume sweets, ensure you are also eating a median amount of fruit, which may mitigate the obesity risk, but do not exceed median sweets intake even with high fruit consumption.

Combining low intake of total vegetables with low intake of fruits creates a synergistic effect that significantly increases the odds of obesity, with the highest risk observed when both are in the lowest quartiles.

Do not skip fruits. The highest risk for obesity occurs when you eat very few vegetables AND very few fruits. Eating both in adequate amounts (top quartiles) offers the strongest protection against obesity.

Weight loss, particularly through GLP-1 based pharmacotherapy (e.g., Tirzepatide), significantly reduces OSA severity and improves cardiometabolic markers like blood pressure, offering a promising alternative or adjunct to CPAP.

Losing weight is one of the most effective ways to treat OSA. New medications like Tirzepatide are showing great promise in reducing breathing pauses and improving blood pressure in obese patients. However, access and cost remain significant barriers.

Allostatic load (AL) represents the cumulative physiological stress and cost of adaptation, and can be measured using an Allostatic Load Index (ALindex) to guide nutrition and exercise interventions.

For elite athletes, consider monitoring allostatic load using biomarkers (like CRP, resting heart rate, HDL, waist-to-height ratio, and HbA1c) to assess cumulative stress. This can help adjust training and nutrition to prevent overtraining and injury.

Intentional weight loss, particularly through bariatric surgery, is associated with improvements in New York Heart Association (NYHA) classification, diastolic function, and reductions in left ventricular (LV) mass index and left atrial size.

Intentional weight loss improves heart function, including diastolic function and reducing left ventricular mass and left atrial size.

Very Low Calorie Diets (VLCD) produce substantial short-term weight loss (10-17 kg) but suffer from gradual attenuation and weight regain over time unless supported by behavioral interventions.

VLCDs are powerful for rapid short-term loss but require medical supervision and a structured reintroduction phase. Without behavioral support, the weight loss is likely to be partially regained over time.

Intermittent Energy Restriction (IER) strategies (TRE, PF, ADF) produce short-term weight loss comparable to Continuous Energy Restriction (CR), with no significant long-term difference between the two approaches.

Choose an IER method (like Time-Restricted Eating) if it helps you adhere to your calorie goals, but do not expect it to be more effective than continuous calorie restriction in the long run. The key is consistency and adherence.

In middle-aged and older adults, weight gain is associated with an increased risk of atherosclerosis (measured by cIMT > 1.0 mm), particularly in those under 65, those with prior cardiovascular events, and those who are overweight or obese at baseline.

For adults over 45, gaining weight is a clear risk factor for developing atherosclerosis, especially if you are already overweight, obese, or have had heart issues. Focus on maintaining a stable, healthy weight rather than chasing rapid weight loss, which may not improve arterial health markers in this age group.

BMI mediates the association between macronutrient quality and phenotypic age acceleration, accounting for approximately 20-30% of the effect.

Dietary changes slow aging partly by helping you maintain a healthy weight. If you are trying to slow biological aging, combining high-quality food choices with weight management strategies will be more effective than diet alone.

Consumption of sugar-sweetened beverages (SSBs) is positively associated with increased waist circumference and BMI in diabetic patients, independent of other dietary factors.

Reduce or eliminate sugar-sweetened beverages to help manage waist circumference and BMI. This is a key dietary modification for diabetic patients.

Mediterranean and low-carbohydrate diets combined with exercise reduce cardiovascular and metabolic risk factors in prostate cancer patients undergoing androgen deprivation therapy (ADT).

If you are undergoing hormone therapy for prostate cancer, adopting a Mediterranean or low-carbohydrate diet alongside regular exercise can help manage metabolic risks like weight gain and blood sugar issues. While the benefits are clear, sticking to these changes long-term can be challenging, so focus on consistency over perfection.

Targeting thermogenesis via β3-adrenergic receptor (β3-AR) activation can increase energy expenditure and promote brown adipose tissue (BAT) activity, offering a complementary mechanism to GLP-1 agonists for obesity management.

Research is actively exploring medications that activate brown fat (thermogenesis) to burn more calories. While not yet standard care, these drugs (like β3-agonists) work by increasing energy expenditure. They may eventually be used alongside GLP-1 medications to overcome weight loss plateaus. Current options are limited by side effects, but newer, more selective drugs are showing promise in clinical trials.