Browse the evidence

Visceral adiposity is an independent risk factor for developing NAFLD and significant fibrosis, whereas subcutaneous adiposity may be associated with regression of the disease.

Focus on reducing abdominal/visceral fat rather than just total body weight. Measures like waist circumference are strong predictors of NAFLD risk. Losing subcutaneous fat may actually help regress NAFLD, but visceral fat reduction is key to preventing progression.

High-intensity exercise causes greater muscle disruption and performance decrements than low-intensity exercise, even when total work volume is equalized.

Prioritize exercise intensity over total volume when managing fatigue. High-intensity sets cause more disruption and slower recovery than low-intensity sets, even if the total work is the same. Adjust recovery time based on intensity, not just volume.

Weight cycling, often a result of conventional dieting, is a stronger predictor of mortality and morbidity risk than adiposity (high BMI) itself.

Avoid yo-yo dieting. Repeated weight loss and regain is more harmful to your health than maintaining a higher stable weight. Focus on stable, healthy habits instead.

Dapagliflozin, an SGLT2 inhibitor, improves hyperglycemia and facilitates weight loss in type 2 diabetic patients by inducing controlled glucosuria, resulting in a urinary loss of approximately 200–300 kcal/day.

If you have type 2 diabetes, this medication works by having your kidneys flush out excess sugar through your urine. This process burns about 200-300 calories a day without you having to diet or exercise more, leading to modest weight loss and better blood sugar control. It is taken once daily.

Lower body fat distribution is independently associated with a reduced risk of metabolic complications, likely due to its greater capacity to store dietary fat and suppress FFA release.

If you store fat in your legs and hips (lower body obesity), you are likely metabolically healthier than someone with the same BMI who stores fat in their belly. Do not try to specifically reduce lower body fat, as this may remove your body's protective fat storage capacity.

Activation of brown adipose tissue (BAT) through chronic cold exposure increases whole-body energy expenditure and improves insulin sensitivity in adult humans.

If you have detectable brown fat, exposing yourself to mild cold (without shivering) for extended periods (e.g., 5 hours) can increase your daily energy expenditure by 150-300 kcal and improve insulin sensitivity. This is not a quick fix but a physiological lever. Obese individuals may have blunted responses, but the potential for 'browning' white fat exists.

Dietary intake of resistant carbohydrates (dietary fibers) increases the abundance of Eubacterium species, which produce short-chain fatty acids (SCFAs) like butyrate that reduce gut inflammation and improve metabolic health.

To support your gut health, prioritize foods rich in resistant carbohydrates, such as whole grains, legumes, and certain fruits. These fibers feed beneficial bacteria like Eubacterium, which produce butyrate to reduce inflammation and support metabolic health. If you are new to high-fiber diets, increase intake gradually to minimize digestive discomfort.

Eubacterium species, particularly E. rectale and E. hallii, play a protective role in Inflammatory Bowel Disease (IBD) by producing butyrate, which reduces inflammation and improves intestinal barrier integrity.

If you have IBD, maintaining a diet rich in resistant carbohydrates can help support Eubacterium species, which produce butyrate to reduce inflammation and support gut barrier integrity. Consult with your healthcare provider for personalized dietary advice.

MBS serves as an effective bridge to other specialty surgeries (joint arthroplasty, hernia repair, organ transplantation) by reducing surgical risks and complications.

If you need joint surgery, hernia repair, or an organ transplant and are obese, getting MBS first can make the other surgery safer, shorter, and less likely to have complications.

Weight gain after breast cancer diagnosis, particularly following adjuvant chemotherapy, is a common occurrence that negatively impacts survival and recurrence risk.

Patients should be aware that weight gain after diagnosis, especially after chemotherapy, is common but harmful. Proactive weight management strategies should be implemented to counteract treatment-induced weight gain.

Walking is as effective as vigorous exercise for reducing coronary event risk when total energy expenditure (MET-hours per week) is equated.

If you prefer walking, you can achieve significant heart protection by walking briskly for about 1.5 hours per week. You do not need to jog or play tennis to get similar coronary benefits, provided you accumulate the same amount of energy expenditure.

Vegan diets are associated with the lowest mean Body Mass Index (BMI) across all age groups compared to meat-eaters, fish-eaters, and vegetarians.

Adopting a vegan diet is associated with the lowest BMI among common dietary patterns. This suggests that removing animal products may naturally support a lower body weight without explicit calorie restriction.

Estrogen promotes fat oxidation and reduces lipogenesis in muscle and liver, and increases uncoupling protein 1 (UCP1) in brown adipose tissue, thereby enhancing energy expenditure.

Estrogen helps your body burn fat more efficiently by activating enzymes that break down fatty acids and by making brown fat burn energy as heat. This is why women typically store less visceral fat than men before menopause.

Heart rate monitoring provides a convenient and relatively inexpensive objective measure of energy expenditure, but its accuracy is limited by inter-individual variability in the HR-VO2 relationship and differences in movement efficiency.

Heart rate monitors are a convenient and affordable way to estimate energy expenditure, but they are not perfectly accurate for everyone. To get the best results, you should calibrate the monitor to your own body through a sub-maximal exercise test. Be aware that HR monitors are less accurate for upper-body exercises if calibrated on lower-body exercises, and during rest or light activity.

Weight loss improves histological disease activity in NASH in a dose-dependent manner, although more than 50% of patients fail to achieve the target weight loss.

Losing weight is the most proven way to improve liver health in NASH, and the more you lose, the better the result. However, getting there is hard for many people, as half of patients in studies didn't reach the target weight. Focus on sustainable, gradual weight loss rather than extreme measures, as even partial loss helps.

Caloric restriction and fasting reduce circulating ob protein and ob mRNA levels in a manner consistent with the reduction in adipose mass.

When you fast or significantly restrict calories, your body produces much less of this fat-regulating hormone. This drop in hormone levels is a normal physiological response to low energy stores and helps signal the brain to conserve energy.

Very low energy diets (VLEDs) defined as <3.4 MJ (800 kcal)/day with full nutritional allowances produce rapid, significant short-term weight loss (1.5–2.5 kg/week) and improve metabolic markers, but do not achieve significantly better long-term weight maintenance compared to conventional low-calorie diets.

A Very Low Energy Diet (VLED) involves consuming less than 800 calories daily for 8-16 weeks, ensuring you get all necessary vitamins and protein. This approach leads to rapid weight loss (1.5-2.5 kg/week) and can significantly improve conditions like type 2 diabetes and hypertension. However, it is not a magic bullet for long-term maintenance; without cognitive behavioral counseling and lifestyle changes, weight regain is common. It is safe for most obese adults with medical supervision but is contraindicated for normal-weight individuals, pregnant women, and those with severe organ disease.

Energy intake-restricted weight loss alone (without exercise) improves peripheral conduit and resistance artery endothelial function in overweight/obese adults.

If you are overweight or obese, losing weight through caloric restriction alone (without needing to exercise) can significantly improve your blood vessel health. This improvement happens in both large and small arteries, reducing cardiovascular risk. Aim for a moderate, sustainable caloric deficit to lose about 10% of your body weight over 3 months, ensuring you get adequate nutrition (at least 1200 kcal/day). This benefit applies to both young and older adults.

Middle-aged and older overweight/obese adults (≥50 years) experience similar or greater improvements in endothelial function from weight loss compared to younger adults (<50 years).

If you are over 50 and overweight, losing weight through diet can significantly improve your blood vessel health, potentially even more than it would for a younger person. Do not assume age limits the vascular benefits of weight loss.

Obese individuals exhibit significantly lower diet-induced thermogenesis (DIT) compared to lean individuals when matched for age and other factors.

Obesity is associated with a reduced ability to burn calories through diet-induced thermogenesis. This means that obese individuals may not burn as many extra calories from food as lean individuals, potentially contributing to weight maintenance challenges.

Smoking cessation causes significant weight gain (mean 1-5.9 kg at 1 year) primarily through increased caloric intake, decreased resting metabolic rate, and increased lipoprotein lipase activity in subcutaneous fat.

Expect to gain 1-6 kg after quitting. This is normal and driven by metabolic changes and increased eating. Use nicotine replacement (gum/patch) or bupropion to help manage this gain and improve quit success rates.

Concurrent training (combining endurance and strength) can impair strength adaptations and muscle hypertrophy, potentially due to a significant caloric deficit and negative energy balance rather than just molecular interference (AMPK/mTORC1).

If you combine cardio and weights, watch your calorie intake. The 'interference' effect is often due to not eating enough to support muscle growth, not just molecular conflicts. Ensure you are in energy balance or a slight surplus to maintain strength gains.

Higher BMI is significantly associated with an earlier onset of injury and illness, and a higher frequency of injuries over time, regardless of exercise prescription.

Your risk of injury is linked to your body weight, not necessarily the exercise you do. Losing weight reduces this risk. If you get injured, consider that your current weight may be placing excessive stress on your body, and weight loss can help delay or prevent future injuries.

Natural menopause is associated with a significant decrease in resting metabolic rate and leisure-time physical activity, leading to accelerated loss of fat-free mass and increased central adiposity.

As you approach menopause, your body naturally burns fewer calories at rest and you may naturally move less during leisure time. This metabolic slowdown, combined with a loss of muscle mass, drives fat gain, particularly around the waist. To counter this, you must proactively manage your energy balance by maintaining or increasing physical activity and preserving muscle mass, rather than assuming weight gain is inevitable.