Browse the evidence

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.

Frequent consumption of beer (a few times per week) and sweets (once a week or more) is associated with an increase in body fat percentage and a decrease in skeletal muscle mass in older adults.

For older adults, drinking beer a few times a week and eating sweets weekly or more is linked to higher body fat and lower muscle mass. Reducing the frequency of these items may help maintain body composition.

Tirzepatide, a dual GLP-1/GIP agonist, may enhance metabolic efficiency and endurance performance by optimizing fat oxidation, delaying glycogen depletion, and improving mitochondrial function.

If you are an endurance athlete using tirzepatide, you may experience improved metabolic efficiency. The drug can help spare glycogen stores and enhance mitochondrial function, potentially supporting longer exercise durations. However, monitor for signs of hypoglycemia during high-intensity training and ensure adequate carbohydrate intake to counteract potential energy deficits.

In individuals with MASLD undergoing ~30% caloric restriction, resistance training preserves skeletal muscle mass and improves functional strength, whereas adding whey protein supplementation (1.5 g/kg/day) provides no additional benefit over resistance training alone (0.8 g/kg/day).

If you have MASLD and are cutting calories significantly, focus on resistance training and getting adequate protein (around 0.8 g/kg/day). Adding extra whey protein (up to 1.5 g/kg/day) does not provide extra muscle or strength benefits in this specific scenario. The energy deficit blunts the potential synergy of high protein and exercise.

Transitioning from non-obese to obese status or maintaining obesity significantly increases the risk of MASLD, with risk escalating with age and magnitude of weight gain.

Gaining weight, especially transitioning from a normal weight to obese, drastically increases your risk of fatty liver disease. The more weight you gain (especially >20kg), the higher the risk. Maintaining a stable, non-obese weight is the most protective strategy.

Bariatric surgery is beneficial for obtaining substantial and long-term weight loss and reducing cardiovascular risk in patients with severe obesity and Type 1 Diabetes.

For T1D patients with severe obesity who cannot achieve weight loss through lifestyle changes, bariatric surgery is a viable option that offers significant, long-term weight loss and cardiovascular benefits.

Preventing gradual population weight gain by addressing a small daily 'energy gap' (approx. 50-100 kcal) through small, sustainable lifestyle changes is a viable international strategy to reduce obesity prevalence.

Focus on making tiny, sustainable changes every day rather than aiming for drastic overhauls. Try to walk 2,000 extra steps daily and cut 100 calories from your diet. These small adjustments can prevent gradual weight gain and are easier to maintain long-term than extreme diets or exercise regimens.

Drinking water induces thermogenesis and increases energy expenditure, potentially aiding weight loss.

Drinking water, especially cold water, may slightly increase your energy expenditure through thermogenesis. While this effect is small and not a primary weight loss strategy, it is a beneficial physiological response. Focus on drinking water before meals to suppress hunger and reduce overall caloric intake, which is a more significant factor.

Severe caloric restriction decreases resting metabolic rate, but regular exercise can help maintain relative resting metabolic rate during such restriction.

If you are restricting calories to lose weight, incorporating regular endurance exercise can help prevent your resting metabolic rate from dropping as much as it might otherwise, particularly when measured relative to your fat-free mass.

Strength training is superior to aerobic training for reducing Body Mass Index (BMI) and body weight in overweight/obese young adults.

If you want to lower your BMI specifically, strength training might offer a slight edge over aerobic exercise, but the difference is negligible. Both are effective for weight loss.

Low-carbohydrate, non-energy-restricted diets produce greater short-term weight loss (6 months) than energy-restricted low-fat diets, but this advantage disappears after 12 months.

If you are overweight, a low-carb diet where you don't count calories or restrict fat will help you lose more weight in the first 6 months than a standard low-fat, calorie-restricted diet. However, do not expect this advantage to last beyond a year; by 12 months, both groups lose roughly the same amount of weight. Focus on adherence, as the low-carb group had better completion rates initially.

Medically supervised very-low-calorie diet (VLCD) programs (e.g., OPTIFAST, Health Management Resources) produce significant short-term weight loss (15-25%) but are associated with high attrition and substantial long-term weight regain (maintaining only 5-9% loss at 1-4 years).

Medically supervised VLCDs like OPTIFAST or Health Management Resources can help you lose 15-25% of your body weight in 3-6 months, but they are expensive and rigid. Most people drop out, and those who finish often regain half the weight within 1-2 years unless they strictly follow a maintenance plan. Use this only if you have medical complications requiring supervision and are prepared for the cost and effort of long-term maintenance.

Low-carbohydrate and low-fat diets produce statistically similar and significant weight loss in overweight and obese adults, with no clinically meaningful difference between named diet brands.

Stop searching for the single 'best' diet. Both low-carb and low-fat diets work equally well for weight loss if you stick with them. Focus on choosing a dietary pattern you can maintain for at least 6-12 months, rather than trying to outsmart the system with a specific brand or macronutrient ratio.

Low carbohydrate, low fat, and moderate macronutrient diets all produce modest weight loss and blood pressure improvements compared to usual diet at six months, but these benefits largely disappear by 12 months.

If you are overweight, switching to almost any popular named diet (low carb, low fat, or moderate) will help you lose a modest amount of weight and lower your blood pressure for the first six months. However, do not expect these benefits to persist without further intervention, as weight loss diminishes and blood pressure improvements largely disappear by the 12-month mark. The specific type of diet matters less than the initial caloric deficit and adherence.

Very-low-calorie (VLC) meal replacement programs (HMR, Medifast, OPTIFAST) produce greater short-term weight loss than counseling, but effects attenuate after 6 months and carry risks of gallstones.

VLC programs like HMR, Medifast, and OPTIFAST can help you lose weight quickly (3-6 months) if you are willing to consume 800-1000 calories daily. However, the weight loss may not be sustained after 6 months, and there is a small risk of gallstones. These programs are best used under medical supervision and for short-term goals.

Zero-calorie alternate-day fasting (ADF) produces weight loss and metabolic improvements equivalent to moderate daily caloric restriction (CR) over 8 weeks, with a higher estimated energy deficit but similar absolute weight loss.

If you struggle with daily calorie counting, try alternating between eating normally and fasting (water/broth only) every other day. This pilot study suggests it works just as well as eating slightly less every day, without increasing the risk of regaining weight. Start with a test fast day to see if you can handle it.

n-3 PUFA supplementation during caloric restriction increases ketogenesis (beta-hydroxybutyrate levels) and reduces lipogenesis (palmitoleic acid levels), indicating enhanced fatty acid oxidation.

n-3 PUFAs may help your body burn fat more efficiently during a diet by increasing ketone production and reducing the creation of new fat.

Time-restricted feeding (16:8 protocol) for 3 months significantly reduces body weight, BMI, and waist circumference in obese women, but does not significantly alter blood biomarkers associated with metabolic syndrome (glucose, lipids, insulin).

If you are obese and sedentary, trying a 16:8 fasting window (e.g., 8 PM to 12 PM) for 3 months will likely help you lose about 4 kg and reduce your waist size. However, do not expect your blood sugar or cholesterol numbers to improve significantly just from the timing; the benefit comes from the resulting weight loss. This approach is easier to stick to than strict calorie counting because you can eat normal foods during your 8-hour window.

Reduction in 30-year cardiovascular disease risk (CVDRisk30y) is significantly correlated with changes in body fat percentage (%BF) and skeletal muscle percentage (%MM) following TRF, even without changes in traditional blood biomarkers.

Focus on losing body fat and maintaining muscle mass through your TRF protocol, as these changes are the primary drivers for lowering your long-term cardiovascular risk score. Traditional blood tests may not reflect these improvements, so tracking body composition is a more useful metric for this specific intervention.

Ramadan intermittent fasting leads to significant reductions in body weight and fat-free mass across all adult demographics, with fat loss occurring primarily in males and younger subjects (<35 years).

If you practice Ramadan fasting, expect to lose weight and some lean mass. Men and younger individuals are more likely to lose fat, while older women may see less fat loss. To minimize muscle loss, prioritize protein intake during non-fasting hours and consider resistance training.

A 45-day VLCKD significantly improves metabolic parameters (weight, BMI, blood pressure, lipids, insulin resistance) regardless of protein source, but animal protein may negatively impact renal markers.

A strict 780-calorie ketogenic diet for 45 days will significantly improve your weight, blood pressure, and blood sugar/insulin levels, regardless of whether you use whey, vegetable, or animal protein. However, if you have kidney concerns, be cautious with animal protein sources as they may slightly worsen renal markers in this context.

Intermittent Energy Restriction (IER) produces weight loss outcomes equivalent to Continuous Energy Restriction (CER) over long-term interventions (≥6 months), with no statistically significant difference in mean weight loss between the two methods.

If you are struggling with the daily rigidity of continuous calorie restriction, try an Intermittent Energy Restriction (IER) approach like the 5:2 diet or Alternate Day Fasting. The evidence shows you will lose the same amount of weight as if you restricted calories every day, but with more flexibility. Focus on consistency over the long term (6+ months) and seek behavioral support to manage the inevitable weight loss plateau that occurs around 6 months.

Obese individuals with a 'thrifty' phenotype, characterized by a large decrease in 24-hour energy expenditure during fasting and a small increase during overfeeding, lose significantly less weight during caloric restriction than those with a 'spendthrift' phenotype.

If you are struggling to lose weight despite strict adherence to a calorie deficit, your body may have a 'thrifty' metabolic phenotype that aggressively reduces energy expenditure. This is a biological reality, not a personal failure. Understanding this can help manage expectations and prevent discouragement, as standard caloric deficits may yield smaller results for you than for others.

For overweight breast cancer survivors, both low-fat and reduced-carbohydrate diets produce equivalent significant weight loss and metabolic improvements when energy intake is restricted, indicating that caloric deficit drives outcomes more than macronutrient composition.

If you are a breast cancer survivor looking to lose weight, you do not need to choose between low-fat and low-carb diets based on ideology. Both work equally well for weight loss and metabolic health as long as you create a consistent calorie deficit (approx. 500 kcal/day) and adhere to professional counseling. Focus on sustainable energy restriction rather than restricting specific macronutrients to extremes.