Browse the evidence

Pre-pregnancy overweight or obesity and excessive gestational weight gain are significant, modifiable risk factors that increase the incidence of GDM.

Maintain a healthy weight before pregnancy. If overweight, aim for gradual weight loss before conceiving. During pregnancy, monitor weight gain closely to ensure it stays within recommended guidelines for your pre-pregnancy BMI.

Low Energy Availability (LEA) causes Relative Energy Deficiency in Sport (RED-S), leading to impaired performance, poor bone health, and increased injury risk in both male and female athletes.

Ensure your daily food intake covers both your training energy expenditure and your body's basic health needs. If you are losing weight unintentionally, feeling fatigued, or getting injured often, you may have Low Energy Availability. Consult a sports dietitian to increase energy availability.

Weight loss of 5-10% significantly improves reproductive outcomes (ovulation, menstrual regularity) and metabolic markers (insulin resistance, lipids) in women with PCOS, regardless of the specific dietary composition used to achieve the weight loss.

Aim for a 5-10% reduction in body weight through a moderate energy deficit (500-750 kcal/day). You do not need to follow a specific restrictive diet (like low-carb or low-fat) to see benefits; any dietary approach that helps you achieve this weight loss will improve insulin resistance, lipids, and reproductive health.

Exercise is highly recommended for osteoarthritis patients, as it reduces pain, improves quality of life, and improves physical function, reversing previous guidelines that discouraged exercise.

If you have osteoarthritis, exercise is one of the best treatments. It reduces pain and helps you function better. Choose low-impact activities like swimming or cycling. If you feel pain during exercise, stop. If you have pain the next day, reduce the amount by half and build up slowly.

Vigorous intensity aerobic exercise produces superior improvements in cardiorespiratory fitness (peak VO2) compared to low or moderate intensity exercise in Type II Diabetes patients.

If your doctor clears you for it, aim for vigorous intensity aerobic exercise. It provides significantly greater improvements in heart and lung fitness (peak VO2) than moderate or low intensity exercise. If you cannot tolerate vigorous intensity, moderate exercise still offers health benefits.

An energy-reduced Mediterranean diet combined with behavioral support and physical activity promotes significantly greater adherence and improvement in cardiovascular risk factors compared to an energy-unrestricted Mediterranean diet in patients with metabolic syndrome.

For individuals with metabolic syndrome, simply following a Mediterranean diet is not enough for optimal metabolic health; you must actively reduce caloric intake (by about 600 calories a day) and increase physical activity. The key to success is not just the food list, but the behavioral support and structured guidance (like monthly coaching) that helps you stick to the reduced calorie target.

Combined diet and physical activity interventions significantly decrease the risk of Type 2 Diabetes in high-risk populations (e.g., prediabetes, obesity, impaired fasting glucose).

If you are at high risk for Type 2 Diabetes (e.g., prediabetes, obesity), combine dietary changes with physical activity. Focus on reducing calories/carbohydrates and engaging in supervised aerobic or resistance exercise. This combined approach is highly effective at preventing the onset of Type 2 Diabetes.

Sustained positive energy balance (energy intake exceeding energy expenditure) is the primary driver of obesity and weight gain.

To lose weight, you must consume fewer calories than you burn. While the quality of your diet (e.g., Mediterranean patterns, limiting sugary drinks) helps manage hunger and health, the fundamental requirement for weight loss is a sustained negative energy balance.

Visceral Adipose Tissue (VAT) and Epicardial Adipose Tissue (EAT) are stronger predictors of incident HFpEF and mortality than Body Mass Index (BMI) alone.

Don't just look at your weight. For heart failure risk, where you store fat matters more. High belly fat (VAT) and heart-adjacent fat (EAT) are major risks, even if your overall weight seems okay. Imaging can help assess this risk.

Adult obesity and overweight significantly increase the odds of PCOS, with adolescents showing even higher odds than adults for the same degree of adiposity.

Maintaining a healthy weight in adulthood reduces PCOS risk, but adolescent weight is even more critical. Adolescents with overweight or obesity face higher odds of developing PCOS than adults with the same conditions. Prioritize healthy weight management during teenage years.

Obesity results from a complex interaction between environmental factors (e.g., ultra-processed foods, reduced physical activity) and genetic susceptibility, rather than environmental factors alone.

Recognize that your genetics may predispose you to weight gain, but this does not mean you are powerless. Understanding this interaction can help you adopt more effective, personalized strategies for managing your weight, such as working with healthcare providers on targeted interventions.

Obesity is a significant risk factor for respiratory diseases, including obstructive sleep apnea (OSA), obesity hypoventilation syndrome (OHS), and asthma, primarily due to mechanical effects on lung volume and airway collapse.

If you have obesity, you are at higher risk for sleep apnea and breathing problems. Excess weight can narrow your airways and reduce lung capacity. Losing weight can help improve breathing and reduce the severity of conditions like asthma and sleep apnea.

Visceral adipose tissue accumulation is a primary risk factor for cardiometabolic disease, whereas subcutaneous fat is metabolically neutral or healthy.

Not all fat is created equal. Visceral fat (around your organs) is dangerous and increases your risk of diabetes and heart disease. Subcutaneous fat (under your skin) is less harmful. Focus on reducing visceral fat through diet and exercise, as this has the biggest impact on your metabolic health.

Bariatric surgery (e.g., Roux-en-Y gastric bypass, sleeve gastrectomy) is an effective treatment for obesity and T2DM, capable of inducing remission of diabetes through both weight-loss-dependent and weight-loss-independent mechanisms.

Bariatric surgery is a powerful tool for treating obesity and Type 2 Diabetes. It can lead to diabetes remission (normal blood sugar without meds) through both weight loss and hormonal changes. It is invasive and carries risks like nutrient deficiencies, so it requires lifelong medical monitoring.

An intensive lifestyle intervention (ILI) combining caloric restriction, structured meal replacements, and increased physical activity produces significant initial weight loss and modest long-term maintenance in adults with type 2 diabetes, but does not reduce cardiovascular morbidity or mortality compared to standard education.

For adults with type 2 diabetes, an intensive lifestyle program focusing on moderate caloric restriction (1200-1800 kcal), structured meal replacements (initially 2 meals/day), and 175 minutes of weekly moderate activity can achieve significant weight loss and improve metabolic markers like A1C and lipids. However, do not prioritize weight loss over glucose management or quality of life. Expect some weight regain after the first year, but maintain the focus on behavioral adherence and metabolic health, as initial losses provide long-term benefits even if full maintenance is difficult.

Weight loss of >10% body weight is required to resolve NASH and regress fibrosis, but this is rarely achieved in routine clinical settings.

Aim for >10% weight loss to potentially reverse NASH and fibrosis, but recognize this is difficult. If you cannot achieve this, focus on a Mediterranean diet to improve liver health and insulin sensitivity even without significant weight loss.

Visceral Adipose Tissue (VAT) and ectopic fat deposition are causal drivers of cardiometabolic disease, whereas subcutaneous fat (specifically gluteofemoral adipose tissue, GFAT) is protective, independent of total body weight.

Focus on preserving subcutaneous fat storage capacity (especially in hips/thighs) and reducing visceral/abdominal fat. This is achieved through diet quality and physical activity, not just weight loss. If you have a 'skinny fat' phenotype (normal weight but high visceral fat), your risk is high. If you have a 'healthy obese' phenotype (high weight but low visceral fat and good metabolism), your risk may be lower than expected.

Lifestyle interventions (diet/exercise) are the cornerstone of obesity treatment but are rarely sufficient for long-term weight maintenance due to metabolic adaptations.

Lose weight through diet and exercise, but expect your body to fight back. Your metabolism will slow down, and hunger hormones will rise. To keep the weight off, you likely need medical support (medication or surgery) in addition to lifestyle changes.

High-carbohydrate overfeeding increases 24-hour energy expenditure (EE) more than high-fat or fasting diets, despite being associated with lower lipid oxidation.

If you are overfeeding, a high-carbohydrate diet may result in higher total energy expenditure than a high-fat diet. This does not mean high-carb is better for weight loss, but it does show that the body burns more total energy when processing high carbs in an overfed state.

Semaglutide reduced major adverse cardiovascular events and all-cause mortality.

Semaglutide may be recommended for patients at risk of cardiovascular events.

No serious adverse events were reported during the trial.

TRE and CR appear to be safe dietary strategies for weight loss in this population.

Tirzepatide showed a favourable safety profile, without increasing the risk of serious adverse events or impacting mortality rates.

Tirzepatide can be used safely in obesity management without significant risk of serious side effects.

Energy intake was greater during the ultra-processed diet by 508±106 kcal/d (p=0.0001).

Practitioners should be aware that ultra-processed diets can lead to higher calorie consumption.

Free-living total daily energy expenditure (TDEE) increased by ~4% in the 20 KKW group.

Increased exercise can enhance daily energy expenditure, which may aid in weight management.