Browse the evidence

Higher levels of physical activity at the time of registry entry are associated with greater magnitude of weight loss maintained, although activity level does not predict the duration of maintenance.

While you don't need to exercise excessively to maintain weight, engaging in higher levels of activity (e.g., >3,500 kcal/week) is associated with having lost more weight initially. However, this does not mean you must keep exercising at that high level to *keep* the weight off; duration of maintenance was not linked to activity level.

During moderate energy deficit (weight loss), higher protein intakes (approx. 1.6 g/kg/day) preserve muscle mass better than lower protein intakes, although this benefit diminishes in severe energy deficit.

If you are cutting calories to lose fat, make sure you eat about 1.6 grams of protein per kilogram of body weight each day. This helps protect your muscle from being broken down for energy. However, if your calorie deficit is extremely severe (more than 40% of your needs), this protection may not be enough, so keep your deficit moderate.

In older adults, higher walking pace (>3 mph) and greater leisure-time physical activity (>845 kcal/week) are independently associated with a significantly lower risk of incident heart failure, whereas high-intensity exercise intensity and walking distance are not.

For older adults, focusing on maintaining a brisk walking pace (over 3 mph) and engaging in moderate leisure activities that burn at least 845 kcal per week is a highly effective strategy for preventing heart failure. You do not need to engage in high-intensity exercise to gain these cardiovascular benefits.

High-intensity interval training improves endurance performance by shifting fuel utilization towards fat oxidation and reducing carbohydrate reliance at submaximal absolute work rates, thereby delaying lactate accumulation and muscle acidosis.

To get faster, focus on training that forces your body to burn fat more efficiently at high speeds and improves your muscles' ability to handle acid buildup. This allows you to sustain higher speeds for longer without 'hitting the wall' or slowing down due to fatigue. This is achieved through high-intensity intervals, not just long, slow rides.

High levels of physical inactivity and consumption of sugary beverages are primary drivers of obesity prevalence in Saudi Arabia, with inactive individuals showing significantly lower risk reduction compared to active males.

Focus on reducing sugary beverage intake and increasing physical activity, even in small amounts, as inactivity is a major driver of obesity in this region.

Female endurance athletes can achieve muscle glycogen supracompensation comparable to men by increasing total energy intake alongside high carbohydrate intake, whereas increasing carbohydrate percentage alone is insufficient.

If you are a female endurance athlete, simply increasing the percentage of carbs in your diet (e.g., to 75%) may not increase your muscle glycogen stores because your total calorie intake is likely too low. To maximize glycogen stores, you must increase your TOTAL energy intake alongside the high carbohydrate diet. This allows you to consume enough absolute carbohydrates (approx. 8-10 g/kg body weight) to trigger supracompensation, matching male responses.

In individuals with type 2 diabetes, achieving a large initial weight loss (8-20%) provides significant long-term improvements in cardiovascular risk factors (HbA1c, SBP, HDL-C, triglycerides) even if the weight is partially or fully regained, whereas maintaining only moderate weight loss (3-8%) fails to sustain these improvements over 4 years.

If you have type 2 diabetes, aiming for a larger initial weight loss (8-20%) is crucial for long-term heart and metabolic health, even if you don't keep all of it. Studies show that losing a significant amount of weight initially improves blood sugar, blood pressure, and cholesterol for years, even if you regain some of it. Simply losing a small amount (3-8%) and keeping it may not be enough to sustain these benefits over 4 years. Focus on achieving a substantial initial loss through lifestyle changes, as the metabolic benefits persist even with partial regain.

Antiobesity medications (AOMs) such as semaglutide and tirzepatide significantly reduce energy intake and appetite, necessitating a shift in nutritional focus from caloric restriction alone to ensuring nutrient density and adequate protein intake to prevent lean mass loss and deficiencies.

When starting semaglutide or tirzepatide, your appetite will drop significantly. Do not just eat less; eat smarter. Prioritize protein (aim for 60-75g daily or up to 1.5g per kg of body weight) and nutrient-dense foods like vegetables, lean meats, and whole grains. This protects your muscle and ensures you get necessary vitamins despite eating smaller portions.

In obese patients with type 2 diabetes, a 1-year lifestyle intervention (caloric restriction and exercise) significantly improves peripheral insulin sensitivity, fasting glucose, and free fatty acid levels, with these metabolic improvements being primarily determined by the magnitude of overall weight and fat mass loss rather than specific changes in regional fat distribution.

For people with Type 2 Diabetes, a one-year program combining a moderate calorie deficit (about 500 calories less per day) and regular exercise (over 175 minutes a week) significantly improves how the body handles sugar and fat. The key takeaway is that losing overall body weight is the most powerful way to improve metabolic health, more so than trying to target specific body areas for fat loss. Men tended to lose more weight and percentage of fat than women in this study, but both sexes saw significant benefits.

Achieving a weight loss of ≥5% is clinically meaningful for improving cardiometabolic risk factors and is the threshold for FDA approval of anti-obesity medications, though greater losses (≥10-15%) are required for remission of conditions like type 2 diabetes and NASH.

Aim for a 5% weight loss as a primary, achievable goal to significantly improve your heart health and metabolic markers. If you have specific conditions like Type 2 Diabetes or NASH, discuss with your doctor if a higher target (10-15%) is needed for remission, but do not let the higher target discourage you from starting with the 5% goal, which brings substantial health benefits.

Lifestyle-based weight loss interventions (diet and physical activity) for adults with type 2 diabetes achieve modest but statistically significant reductions in body weight and HbA1c compared to usual care.

Engage in structured lifestyle interventions focusing on diet and physical activity. While the average weight loss is modest (around 3-5 kg), it is statistically significant and improves health markers like HbA1c. Consistency is key, as maintenance of these effects is difficult and requires ongoing effort.

Lifestyle interventions, specifically a Mediterranean diet and 150-300 minutes of moderate or 75-150 minutes of vigorous exercise weekly, are recommended to induce weight loss and improve cardiovascular risk factors in patients with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD).

Adopt a Mediterranean-style diet focused on reducing total calories, saturated fats, and processed sugars while increasing intake of fish, vegetables, nuts, and fiber. Combine this with at least 150 minutes of moderate exercise (like brisk walking) or 75 minutes of vigorous exercise per week. Aim for a 5-10% reduction in body weight to significantly improve liver health and cardiovascular risk.

Increasing physical activity, specifically walking, is a key factor in preventing weight gain and maintaining weight loss, with successful maintainers engaging in approximately one hour of moderate-intensity activity daily.

To prevent weight gain, aim for about 2,000 extra steps a day. If you have lost weight, aim for about an hour of moderate activity daily to maintain it. Use a pedometer to track your progress and integrate walking into your daily routine.

Weight loss is achieved through a negative energy balance, and macronutrient composition (low-carb vs. low-fat) has no major independent impact on weight loss outcomes when caloric deficit is matched.

To lose weight, you must consume fewer calories than you burn. The specific type of diet (low-carb, low-fat, etc.) matters less than maintaining a consistent daily energy deficit of about 500 kcal. Adjust your intake as you lose weight to maintain the deficit.

Structured low-calorie total diet replacement (825–853 kcal/day) for 12–20 weeks followed by food reintroduction can induce remission of type 2 diabetes in a significant subset of patients, defined as HbA1c <48 mmol/mol without diabetic medications.

If you have Type 2 Diabetes and obesity, ask your doctor about a Total Diet Replacement (TDR) program. This involves consuming 825-853 calories a day for 3-5 months using specific meal replacements, followed by a gradual return to solid foods. This approach has been shown to put diabetes into remission for over a third of participants, especially if you lose 10kg or more. It requires medical supervision to adjust your diabetes medications safely.

Bariatric surgery is a safe, effective, and durable treatment for severe obesity in people with Type 2 Diabetes, leading to significant weight loss and high rates of diabetes remission, yet it remains significantly underutilized.

If you have severe obesity and Type 2 Diabetes, bariatric surgery is the most effective treatment for long-term weight loss and diabetes remission. It is recommended for those with a BMI over 35, or over 30 if your diabetes is recent. Despite being safe and effective, it is underused. Discuss with your specialist if you are a candidate, keeping in mind the need for lifelong vitamin supplementation and monitoring.

Weight loss of 15 kg can induce remission of Type 2 Diabetes in approximately 70% of individuals, and even smaller weight losses (5 kg) improve insulin sensitivity and glycemic control, highlighting the primacy of lifestyle interventions in diabesity management.

Losing weight is the most powerful tool for managing Type 2 Diabetes. Losing 15 kg can put diabetes into remission for about 70% of people. Even losing 5 kg improves how your body uses insulin. To succeed, combine dietary changes (like Mediterranean or low-carb diets) with regular exercise. Focus on stepwise, realistic goals rather than quick fixes to ensure long-term success.

Comprehensive lifestyle management, including reduced calorie diets, increased physical activity, and behavioral intervention, is the foundational cornerstone of all obesity treatment and is appropriate for all individuals who may benefit from intervention.

Start with a caloric deficit of 500-750 kcal per day and aim for at least 150 minutes of aerobic activity weekly. To succeed, you need more than just willpower; engage with a structured program or a trained interventionist for at least 14 sessions over six months to achieve a 5-10% weight loss. Maintain this with monthly check-ins.

Detrimental changes in physical activity (decrease) and energy intake (increase) over time are predictive of greater weight regain, whereas improvements in both are associated with the least weight regain.

Consistency and improvement matter more than your starting point. If you reduce your activity or increase your food intake over time, you are likely to regain weight. Conversely, increasing activity and decreasing intake leads to the best maintenance outcomes. Monitor your trends, not just your baseline.

Replacing saturated fatty acids (SFA) with polyunsaturated fatty acids (PUFA), particularly plant-based ePUFAs, is associated with less long-term weight gain and reduced risk of obesity in prospective cohort studies.

To prevent age-related weight gain, replace saturated fats (found in animal products) with polyunsaturated fats (found in plant oils, nuts, seeds). This substitution is associated with less long-term weight gain compared to diets high in saturated fats or trans fats.

In adults with type 2 diabetes, a 10% reduction in fat mass (FM) over one year is significantly associated with a lower risk of incident heart failure (HF), whereas changes in lean mass (LM) are not significantly associated with HF risk.

If you have type 2 diabetes, losing fat mass is a powerful way to lower your risk of heart failure. This study shows that a 10% drop in fat mass significantly reduces risk, while losing muscle mass does not have the same protective effect. Focus your lifestyle efforts on reducing fat through diet and activity, rather than worrying excessively about losing muscle during weight loss.

Time-restricted feeding (16:8) and macronutrient-based diets (MBD) produce equivalent reductions in body weight, fat mass, and waist circumference in physically active, overweight individuals, provided adherence exceeds 70%.

You can lose fat using either a 16:8 fasting window or by tracking macros/calories, as long as you maintain a caloric deficit. The key is adherence: you must follow the plan more than 70% of the time. If you struggle with counting macros, try 16:8. If you struggle with fasting windows, track macros. Both require consistency to see changes in weight and waist size.

For type 2 diabetes prevention, reducing body weight (BMI) is more effective than improving cardiorespiratory fitness (CRF) alone.

To prevent type 2 diabetes, losing weight is more impactful than just getting fit. If you are overweight, focus on weight loss first, as it reduces diabetes risk more significantly than improving fitness alone. However, maintaining fitness is still beneficial and should be part of your overall strategy.

Lifestyle interventions achieving 7-10% body weight loss are effective in resolving nonalcoholic steatohepatitis (NASH) and regressing fibrosis in patients with metabolic-associated fatty liver disease (MAFLD).

To reverse liver inflammation and fibrosis, you need to lose 7-10% of your body weight through diet and exercise. Losing more than 10% can even reverse scarring (fibrosis). The hardest part is sticking with it, as most people fail to reach these targets. Combine a calorie-restricted diet (like the Mediterranean diet) with 150-300 minutes of moderate exercise per week.