Browse the evidence

Weight reduction interventions, including lifestyle changes and ACE inhibition, reduce glomerular hyperfiltration and proteinuria in obese patients with CKD.

If you are overweight and have diabetes, losing weight through diet and exercise can cut your risk of developing kidney disease by 30%. This benefit comes from reducing the strain on your kidneys, not just from better blood sugar control.

GLP-1 receptor agonists (semaglutide) significantly improve quality of life and exercise capacity in obese patients with heart failure with preserved ejection fraction (HFpEF), primarily through substantial weight loss.

For obese patients with HFpEF, GLP-1 agonists like semaglutide are effective at improving quality of life and exercise capacity, largely by driving significant weight loss (approx. 13%). While these drugs are promising, their benefits appear closely tied to weight reduction rather than unique cardiac mechanisms. Therefore, they should be viewed as one option among others, including caloric restriction and supervised exercise, which may offer similar benefits at a lower long-term cost.

Achieved weight loss, rather than dietary protein quantity or red meat inclusion, is the primary driver of improved glucose control and body composition in adults with type 2 diabetes.

If you have Type 2 Diabetes, focus on losing weight rather than obsessing over whether your protein intake is 'high' or if you eat beef. This study shows that losing weight improves your blood sugar and body composition regardless of whether you eat a high-protein diet with beef or a normal-protein diet without it. Choose a dietary pattern you can stick to that creates a calorie deficit, and the health benefits will follow.

Roux-en-Y gastric bypass (RYGB) reduces all-cause and cardiovascular mortality in obese individuals with type 2 diabetes primarily through weight reduction (BMI decrease), rather than through improvements in glycemic control (HbA1c), blood pressure, or lipid profiles.

For obese individuals with type 2 diabetes, Roux-en-Y gastric bypass significantly reduces the risk of death, primarily by lowering body weight. While blood sugar, blood pressure, and cholesterol often improve after surgery, these improvements do not appear to be the main reason for the longevity benefit. The weight loss itself is the key driver, acting as a proxy for reduced mechanical stress and inflammation. Therefore, achieving and maintaining significant weight loss is critical for mortality reduction in this population.

Adding exercise to a low-carbohydrate diet improves cardiorespiratory fitness (VO2peak) and reduces systolic blood pressure, but does not provide additional weight loss benefits compared to the low-carbohydrate diet alone.

If you are doing a low-carb diet, adding exercise won't necessarily make you lose weight faster than the diet alone. However, it will significantly improve your heart health, blood pressure, and mental well-being. Do exercise for these health benefits, not just for extra weight loss.

Self-reported dietary intake methods (Remote Food Photography Method) significantly underestimate energy intake compared to doubly labelled water (DLW) derived estimates, leading to an overestimation of the prevalence of Low Energy Availability (LEA) in female soccer players.

If you are a female soccer player or coach using food photography or logs to track energy availability, be aware that you are likely under-reporting intake by about 22%. This means you might think you have Low Energy Availability (a risk factor for injury and hormonal issues) when you actually don't. Do not make drastic dietary changes based solely on self-reported data without considering this potential under-reporting bias.

Very Low-Calorie Diets (VLCDs) produce rapid weight loss (15-25% in 3-6 months) but are associated with high attrition and significant weight regain (>50%) at 1-2 year follow-ups.

VLCDs can help you lose weight quickly (15-25% in a few months), but they are hard to sustain. Most people regain more than half the weight within 1-2 years if they don't have a structured plan to transition to normal food and maintain lifestyle changes. Use VLCDs only under medical supervision and as part of a broader program.

High consumption of energy-dense nutrient-poor (EDNP) foods (salty snacks, cookies, candy) contributes as many daily kilojoules as sugar-sweetened beverages (SSB) in low-income Southern US populations, meaning interventions targeting only SSB may fail to reduce total energy intake if EDNP consumption remains high.

If you are trying to cut calories, don't just stop drinking soda. In low-income communities, salty snacks, cookies, and candy contribute just as many calories as sugary drinks. To see real results, you need to reduce both sugary beverages AND energy-dense nutrient-poor foods.

A decrease in total energy intake is independently associated with a loss of muscle mass in patients with Type 2 Diabetes, even when adjusting for physical activity and hypoglycemic agents.

When reducing calories for Type 2 Diabetes, be aware that muscle mass may also decrease. To counteract this, ensure your diet includes adequate protein and incorporate resistance training. Monitoring body composition is important to ensure you are losing fat, not muscle.

Metabolic adaptation (reduced resting metabolic rate beyond prediction based on body composition) persists for at least six years after massive weight loss from extreme caloric restriction and exercise, contradicting claims that baseline measurement errors or stress artifacts explain the finding.

If you have lost a significant amount of weight, expect your metabolism to slow down more than predicted by your new size alone. This is a biological reality, not a personal failure. This adaptation can persist for years, meaning you will likely need to maintain a lower calorie intake or higher activity level than someone who never was obese to keep the weight off. Plan for long-term management, not a quick fix.

Metabolic adaptation during weight loss involves a 15-20% reduction in daily energy expenditure beyond what is expected from mass loss, which persists until the previous weight is regained.

When you lose weight through dieting, your body burns 15-20% fewer calories than expected for your new size. This 'metabolic adaptation' does not go away over time; it stays until you regain the weight. This is why maintaining weight loss through diet alone is so difficult—you must eat significantly less than a healthy person of your new weight would.

Long-term caloric restriction (25% reduction for 24 months) induces metabolic adaptation (adaptive thermogenesis) in sleeping energy expenditure that exceeds predictions based on changes in body mass alone, with the effect persisting at 24 months when assessed using advanced MRI-derived organ and tissue mass models.

If you restrict calories by 25% for two years, your body will adapt by lowering its energy expenditure more than expected from weight loss alone. This 'metabolic adaptation' is real and persists, especially when looking at organ-level changes. To manage this, focus on preserving muscle mass through resistance training and protein intake, as the study shows lean tissue loss is part of the equation, though not the whole story of metabolic slowdown.

While fat-free mass gains are similar, 16:8 TRE results in less fat mass accumulation and lower total training volume compared to continuous feeding during a caloric surplus.

Be aware that if you switch to an 8-hour eating window, you might naturally train for less total volume and accumulate slightly less fat than if you ate all day, even in a surplus. This isn't necessarily bad—it might mean you are more efficient with your energy—but it is a trade-off to consider if your goal is maximum fat gain (bulking).

Obesity increases perioperative morbidity and technical complexity in gastrointestinal cancer surgery, including higher rates of anastomotic leak and surgical site infection.

If you are obese and undergoing gastrointestinal cancer surgery, discuss the increased risk of complications with your surgeon. Preoperative weight loss may be recommended to reduce these risks.

Sustained weight loss of at least 5% achieved through pharmacotherapy or bariatric surgery is associated with a reduced risk of obesity-related cancers.

To reduce cancer risk, weight loss must be sustained over the long term. Losing at least 5% of body weight and keeping it off is associated with lower cancer risk. For those who struggle to maintain weight loss, pharmacotherapy or bariatric surgery can help sustain the loss, thereby preserving the cancer-protective benefits.

Orlistat, a lipase inhibitor, promotes modest weight loss (approx. 2-3 kg over 24 weeks) by blocking the absorption of dietary fat, but is associated with gastrointestinal side effects and potential fat-soluble vitamin deficiencies.

Orlistat is an older weight loss drug that works by blocking fat absorption. It leads to modest weight loss (around 2 kg over 6 months) and requires taking a capsule with each meal. Common side effects include oily stools and abdominal pain, which can be managed by keeping dietary fat low. You should also take a multivitamin at a different time of day to avoid nutrient deficiencies.

Very-low-carbohydrate diets enhance human T-cell immunity by inducing ketone body production (specifically beta-hydroxybutyrate), which reprograms T-cells to favor oxidative metabolism, improves cellular energy supply, and increases T memory cell formation.

If you reduce carbohydrate intake significantly, your body produces ketones like beta-hydroxybutyrate. This shift can reprogram your T-cells to use energy more efficiently via oxidative metabolism, potentially enhancing their ability to form long-term memory and respond to pathogens.

Weight loss mitigates the metabolic risk associated with high refined grain and carbohydrate intake, whereas weight gain exacerbates it.

If you are gaining weight, reducing refined grains is crucial to lowering metabolic syndrome risk. If you are losing weight, keeping refined grains below the median intake further reduces risk. Weight management modulates the impact of grain quality.

Following behavioral weight loss, the body enters a physiological state characterized by adaptive thermogenesis (declines in energy expenditure beyond those attributable to changes in body composition) and increased energy intake, which drive weight regain.

After losing weight, your body biologically fights to regain it by lowering your energy expenditure and increasing hunger. This is a normal physiological response, not a personal failure. To maintain weight loss, you must account for these biological changes, likely requiring ongoing behavioral support and potentially adjusted energy intake/expenditure strategies, rather than relying on the same intensity of effort used during the weight loss phase.

Using different prediction equations (Katch-McArdle vs. BIA-derived) to estimate Resting Metabolic Rate (RMR) during weight loss yields significantly different conclusions regarding the presence of metabolic adaptation (MA), with Katch-McArdle suggesting increased metabolic efficiency (increased aRMR) while BIA suggests decreased efficiency (decreased aRMR).

When tracking weight loss, do not rely on a single prediction equation to judge your metabolic health. This study shows that different formulas can contradict each other regarding metabolic adaptation. To minimize this error, prioritize preserving fat-free mass (muscle) through adequate protein intake (approx. 2.0 g/kg FFM as used in the study) and resistance training, as this stabilizes the metabolic rate more reliably than any single calculation method.

Weight cycling (losing and regaining weight) is associated with unfavorable cardiometabolic profiles and increased cardiovascular disease risk.

Avoid yo-yo dieting. While losing weight is good, regaining it repeatedly is worse for your heart than staying at your starting weight. Focus on maintaining your weight loss through sustainable lifestyle changes.

Intragastric balloons (IGB) are effective for weight loss but carry risks of dehydration, readmission, and reintervention, with saline-filled balloons outperforming air-filled ones.

If lifestyle changes haven't worked, an intragastric balloon can be a helpful bridge. Choose a saline-filled balloon over an air-filled one for better results. Be prepared for a 6-12 month commitment and take prescribed stomach acid reducers to prevent discomfort. The risk of serious complications is low, but dehydration is a common side effect.

Tirzepatide treatment (5-15 mg weekly) significantly reduces serum uric acid (SUA) levels in adults with obesity or overweight, with weight reduction explaining 72.7% of this effect.

If you have obesity or overweight and are concerned about gout or high uric acid, tirzepatide (a once-weekly injection) can significantly lower your uric acid levels. Most of this benefit comes from the weight loss it causes, but it may also have direct effects. This makes it a potentially useful tool for managing gout risk in people with obesity, in addition to helping with weight loss.

Ramadan fasting significantly impairs anaerobic power (Wingate peak and mean power) and upper-body strength (bench press), but does not significantly affect lower-body maximal strength (leg press), explosive power (countermovement jump), or isometric strength (handgrip).

During prolonged fasting, expect a drop in your ability to perform high-intensity, short-duration efforts (like sprints or heavy upper-body lifts). Your leg strength and vertical jump may remain stable, but prioritize recovery and nutrition strategies for anaerobic tasks.