Browse the evidence

In normal weight individuals, both weight loss and weight gain are associated with an increased risk of cardiovascular disease (CVD) compared to weight maintenance.

If you are normal weight, try to maintain your current weight. Both losing and gaining weight were associated with a higher risk of cardiovascular disease compared to staying stable. This may be because weight loss in normal weight individuals can be a sign of underlying illness.

In individuals with obesity, weight gain is associated with a higher risk of cardiovascular disease (CVD) compared to weight maintenance.

If you have obesity, avoiding weight gain is important for cardiovascular health. Gaining weight was associated with a higher risk of CVD compared to maintaining your current weight. Focus on strategies to maintain your current weight.

In older patients with diabetes mellitus, energy intake between 25 and 35 kcal/kg of body weight per day is associated with the lowest all-cause mortality, forming a U-shaped relationship where both lower and higher intakes increase mortality risk.

Older adults with diabetes should aim for an energy intake of 25 to 35 kcal per kilogram of body weight per day. This range is associated with the lowest risk of death. Both eating significantly less than this (leading to potential malnutrition/sarcopenia) and significantly more (excessive nutrition) increases mortality risk. This optimal range may be higher than what is traditionally calculated using standard body weight formulas.

Exogenous ketone sources, specifically medium-chain triglycerides (MCTs) and ketone esters, increase energy expenditure and reduce energy intake when consumed in the context of high carbohydrate availability.

If you are eating a high-carbohydrate diet, adding MCT oil or ketone esters may slightly boost your energy expenditure and reduce your hunger. However, the effect is small ('slightly enhanced weight loss') and not a substitute for a balanced diet. It is not a magic bullet.

Bariatric surgery results in greater weight loss and higher rates of type 2 diabetes remission compared to sleeve gastrectomy, and is associated with reduced nephropathy and major adverse cardiovascular events.

For individuals with severe obesity and type 2 diabetes who have not achieved remission with lifestyle changes or medications, bariatric surgery (particularly Roux-en-Y gastric bypass) can be a highly effective option. It offers greater weight loss and diabetes remission rates than other surgical options like sleeve gastrectomy, along with reduced heart and kidney risks, though it carries higher surgical risks.

Fasted cardiovascular exercise is commonly recommended by bodybuilding coaches (67%), primarily to synergize with fat-burning supplements like yohimbine and clenbuterol, despite systematic reviews showing no superiority over fed cardio for fat loss in general populations.

Bodybuilding coaches frequently prescribe fasted cardio (67% of respondents) not because it burns more fat than fed cardio, but to allow the use of fat-burning supplements like yohimbine or clenbuterol. If you are not using these specific supplements, fasted cardio offers no fat-loss advantage over fed cardio. Focus on total weekly energy expenditure and recovery.

High-glycemic load (GL) diets reduce total energy expenditure (TEE) compared to low-carbohydrate or low-GL diets, even when calories and weight are matched.

When maintaining weight loss, choose lower-carbohydrate or lower-glycemic load foods to support a higher metabolic rate compared to high-carbohydrate diets.

A 12-month Mediterranean diet intervention in firefighters leads to modest but significant improvements in specific cardiometabolic markers, specifically body fat percentage and LDL cholesterol, at 6 months, though these effects may not persist or reach significance after multiple comparison corrections.

While the diet improves adherence, expect modest changes in body fat and LDL cholesterol, particularly in the first 6 months. Do not expect dramatic shifts in these specific markers, and be aware that statistical significance may be lost when accounting for multiple health metrics.

Incorporating biological factors (hunger, satiety, metabolic adaptation) into social cognitive theory improves long-term weight loss maintenance compared to traditional behavioral interventions that ignore these biological drivers.

If you are struggling to maintain weight loss despite eating right and exercising, recognize that your body is likely fighting back with increased hunger and a slower metabolism. This is a biological response, not a failure of willpower. To succeed, you must manage these biological signals directly by prioritizing high-satiety foods (high protein, fiber, low energy density) and strategic meal timing, rather than relying solely on mental discipline or distraction techniques.

Preventing 'weight creep' (0.5-1 kg/year gain) through low-intensity lifestyle interventions is a more achievable and effective strategy for OA management than focusing solely on significant weight loss in already obese individuals.

Focus on preventing the slow, yearly weight gain (0.5-1kg) rather than just trying to lose large amounts of weight. Make small, sustainable changes to your diet and activity (e.g., slightly less food, slightly more movement) to create a small energy deficit. This is easier to maintain and significantly reduces the risk of needing knee replacement surgery.

Successful long-term weight loss maintenance (≥5% loss sustained for ~4.5 years) significantly lowers serum total cholesterol compared to unsuccessful maintainers, but does not significantly improve triglycerides, LDL, HDL, fasting glucose, or HbA1c in the long term.

Maintaining significant weight loss (≥5%) for several years is associated with lower total cholesterol compared to regaining the weight. However, do not assume this will automatically fix your triglycerides, LDL, or blood sugar. Long-term maintenance alone may not be enough to normalize all cardiometabolic markers; ongoing monitoring and potentially other lifestyle or medical interventions are necessary for comprehensive heart health.

Higher Body Mass Index (BMI) is significantly correlated with lower VO2 max in martial arts athletes, indicating that increased body mass is associated with reduced aerobic capacity.

For martial arts athletes, maintaining a healthy BMI is crucial for maximizing aerobic capacity (VO2 max). If your BMI is high, it may be limiting your endurance. Focus on nutritional periodization and body composition management to improve your VO2 max, which is a key determinant of performance in sports like Karate, Judo, and Kempo.

Intentional weight loss interventions (lifestyle, pharmacotherapy) are associated with improved cardiovascular outcomes, including reduced mortality and incidence of cardiovascular events, although the magnitude of benefit and specific effects on cardiovascular mortality remain controversial and dependent on the weight loss extent.

This paper is a protocol for a future study, so no specific advice can be given yet. However, it highlights that intentional weight loss through lifestyle changes (diet, exercise) or medication is generally recommended to improve heart health, despite conflicting evidence on whether it strictly reduces death rates from heart disease. Patients should consult guidelines for managing obesity to reduce cardiovascular risk factors like blood pressure and lipids.

Significant improvements in metabolic parameters (lipid profile, blood pressure, fasting glucose) are achieved primarily in subjects with lower initial excess weight (overweight or Class I obesity) and those who lose ≥5% of their initial body weight.

If you are overweight or have Class I obesity, a lifestyle program is likely to improve your blood pressure and lipids. If you have Class II or III obesity, standard lifestyle changes may not significantly improve metabolic markers, and you might need more intensive support or medical intervention. Losing 5% of your body weight is a key threshold for seeing glucose improvements.

Moderate-intensity aerobic exercise (3-6 Mets/h fast walking) is as effective as intensive exercise (8-10 Mets/h treadmill running) for improving fatty liver, body weight, waist circumference, and blood pressure in obese patients with NAFLD.

If you have fatty liver or obesity, you do not need to run hard to see benefits. Walking fast for 30 minutes, five days a week, improves your liver, weight, and blood pressure just as well as running. Focus on consistency rather than intensity.

Genetic variants in the FTO gene increase obesity susceptibility, but this genetic risk can be reduced by approximately 30% through engagement in physical activity.

If you have a family history of obesity, do not assume you are destined to gain weight. Research shows that regular physical activity can significantly blunt the impact of common obesity genes (like FTO). Prioritize consistent exercise as a primary tool to manage your genetic risk.

High ultra-processed food intake is associated with significantly higher BMI in young active adults when controlling for recreational physical activity levels.

Even if you exercise regularly, a diet high in ultra-processed foods may still lead to a higher BMI. Focus on reducing UPF to manage body weight effectively, rather than relying solely on exercise.

Intragastric balloons (IGBs) and oral superabsorbent hydrogels (OSH) provide moderate weight loss (10-15% TBWL for IGBs, ~10% for OSH) by physically occupying stomach volume and triggering satiety signals, serving as minimally invasive alternatives for patients who are not surgical candidates.

If you are not a candidate for surgery or drugs, or want a temporary, non-surgical option, intragastric balloons or hydrogels can help. Balloons are placed in the stomach for 6-12 months to take up space and make you feel full, leading to 10-15% weight loss. Hydrogels are swallowed before meals and expand to trigger satiety. These are less effective than surgery or GLP-1 drugs long-term but offer a middle ground for those avoiding needles or surgery.

Moderate (~10%) weight loss improves systemic cardiometabolic risk factors (plasma insulin and arterial stiffness) similarly in both childhood-onset (CO) and adult-onset obesity (AO) populations.

Losing about 10% of your body weight through diet and exercise significantly improves your blood vessel health (arterial stiffness) and insulin sensitivity, regardless of whether you became obese as a child or as an adult. This is a robust benefit of weight loss that applies to everyone with obesity.

Commonly consumed South Indian breakfast meals are high in available carbohydrates (ranging from 49.6% to 71.8% on a dry basis), which contributes significantly to daily energy intake and potential weight gain if consumed in excess.

If you eat South Indian breakfasts like dosa, idly, or vada, know that they are high in carbohydrates. To manage your weight, be mindful of portion sizes and balance these meals with lower-carb options later in the day, as excess carbohydrates contribute to weight gain.

Metabolic adaptation (energy expenditure below expected levels) and appetite adaptation (increased energy intake) are coregulated and inseparable factors in weight regain.

Don't try to fix weight maintenance by only focusing on diet or only on exercise. Your body's hunger signals and energy burn are linked. Effective long-term strategies need to address both sides of the energy balance equation simultaneously.

Lifestyle modifications (diet, exercise, behavioral therapy) are foundational but have limited efficacy for severe obesity when used alone.

Lifestyle changes (diet, exercise, counseling) are the foundation of obesity treatment. However, for severe obesity (BMI ≥35), they are often not enough on their own. Combine them with medical or surgical options for best results.

A 5-10% weight loss in adults is often sufficient to obtain substantial health benefits from decreasing obesity-related comorbidities, challenging the goal of maximum weight loss in the shortest time.

You do not need to lose a massive amount of weight to see major health improvements. Losing just 5-10% of your body weight can significantly reduce obesity-related health risks. Focus on achieving this sustainable target rather than aiming for rapid, maximum weight loss.

Vegetarian diets may enhance endurance performance (VO2 max and time to exhaustion) compared to omnivorous diets, likely due to higher carbohydrate availability.

If your primary goal is endurance, a vegan or vegetarian diet may offer a slight advantage in VO2 max and time to exhaustion compared to an omnivorous diet, potentially due to higher carbohydrate intake.