Browse the evidence

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.

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.

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.

Short-term increases in energy intake and body weight observed in ultra-processed food (UPF) feeding trials are primarily mediated by higher energy density rather than the processing status itself, and these effects attenuate over time.

Do not demonize ultra-processed foods (UPF) based solely on their processing status. The observed weight gain in short-term studies is largely driven by high energy density, which tends to decrease as the body adapts. If you choose to eat UPF, ensure they are matched for energy density and nutrient quality with less processed options, as no inherent adverse effect on energy intake was found in controlled trials using conservative substitutions.

Sirona, a gastro-retentive dual-network polymer hydrogel, promotes weight loss and reduces dietary intake in adults with obesity (BMI 30-40 kg/m2) through mechanical gastric retention, demonstrating a large effect size compared to placebo in a 12-week pilot trial.

Sirona is a non-drug weight loss option for people with obesity (BMI 30-40). It works by swelling in the stomach to help you feel full, leading to reduced food intake and weight loss. In a short trial, it helped people lose about 4% of their body weight over 12 weeks, which is a significant amount. Side effects like nausea are common at first but are usually mild and go away. It requires taking pills daily with water on an empty stomach, along with basic healthy eating and exercise advice.

Hypertension is associated with urban living, older age, insufficient fruit and vegetable intake, and low physical activity.

Public health initiatives should address these risk factors to manage hypertension.

Diabetes is associated with urban residence, older age, low fruit and vegetable consumption, high salt intake, and low physical activity.

Strategies to reduce diabetes risk should focus on dietary improvements and physical activity.

Enablers of medication adherence include patient education, family support, effective patient-provider communication, and structured diabetes education programmes.

Enhancing these enablers may lead to better adherence outcomes.

Individuals with diagnosed T2DM reported higher HEI component scores for added sugar, indicating lower sugar intake, but lower scores for sodium and refined grains, indicating higher intake of these components, compared to those without diagnoses.

Dietary management for T2DM should address both sugar intake and the high consumption of sodium and refined grains.

The main effect of eating disorder category on UPF consumption was statistically significant after adjusting for age, sex, and BMI.

The significant association suggests that eating disorder categories should be considered in dietary evaluations.

Formula diet-based lifestyle interventions may lead to greater weight loss compared to modern antidiabetic drugs, while maintaining comparable long-term glycemic control in obese type 2 diabetes patients.

If you have type 2 diabetes and are obese, consider a formula diet-based lifestyle intervention. It may help you lose more weight than antidiabetic drugs while keeping your blood sugar under control, at least in the short term.

Preoperative weight stabilization for 3-6 months is a critical criterion for body contouring surgery to ensure aesthetic results and patient safety.

Do not rush into body contouring surgery immediately after losing weight. Wait until your weight has been stable for at least 3-6 months (often 15-18 months after bariatric surgery) to ensure the best aesthetic result and minimize the risk of needing revision surgery.

Weight loss, particularly through GLP-1 based pharmacotherapy (e.g., Tirzepatide), significantly reduces OSA severity and improves cardiometabolic markers like blood pressure, offering a promising alternative or adjunct to CPAP.

Losing weight is one of the most effective ways to treat OSA. New medications like Tirzepatide are showing great promise in reducing breathing pauses and improving blood pressure in obese patients. However, access and cost remain significant barriers.

Allostatic load (AL) represents the cumulative physiological stress and cost of adaptation, and can be measured using an Allostatic Load Index (ALindex) to guide nutrition and exercise interventions.

For elite athletes, consider monitoring allostatic load using biomarkers (like CRP, resting heart rate, HDL, waist-to-height ratio, and HbA1c) to assess cumulative stress. This can help adjust training and nutrition to prevent overtraining and injury.

Very Low Calorie Diets (VLCD) produce substantial short-term weight loss (10-17 kg) but suffer from gradual attenuation and weight regain over time unless supported by behavioral interventions.

VLCDs are powerful for rapid short-term loss but require medical supervision and a structured reintroduction phase. Without behavioral support, the weight loss is likely to be partially regained over time.

Intermittent Energy Restriction (IER) strategies (TRE, PF, ADF) produce short-term weight loss comparable to Continuous Energy Restriction (CR), with no significant long-term difference between the two approaches.

Choose an IER method (like Time-Restricted Eating) if it helps you adhere to your calorie goals, but do not expect it to be more effective than continuous calorie restriction in the long run. The key is consistency and adherence.

Mediterranean and low-carbohydrate diets combined with exercise reduce cardiovascular and metabolic risk factors in prostate cancer patients undergoing androgen deprivation therapy (ADT).

If you are undergoing hormone therapy for prostate cancer, adopting a Mediterranean or low-carbohydrate diet alongside regular exercise can help manage metabolic risks like weight gain and blood sugar issues. While the benefits are clear, sticking to these changes long-term can be challenging, so focus on consistency over perfection.

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.

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.

Intermittent fasting (IF) produces a statistically significant greater reduction in Body Mass Index (BMI) compared to continuous energy restriction (ER), although the absolute difference in total body weight loss is not statistically significant.

If you are trying to lose weight, intermittent fasting may help you reduce your BMI slightly more than just counting calories every day, even if the scale doesn't move much faster. Try a 16:8 schedule (fast for 16 hours, eat within 8 hours) or alternate-day fasting. Be aware that you might feel dizzy, while those just cutting calories might get more headaches. The key is consistency with whichever method you choose.

Intermittent fasting and continuous energy restriction produce similar improvements in blood pressure (systolic and diastolic), LDL cholesterol, and HDL cholesterol, with no statistically significant differences between the two methods.

If your goal is to lower blood pressure or improve cholesterol, you do not need to fast. Reducing your overall calorie intake through standard dieting is just as effective as intermittent fasting for these specific heart health markers. Focus on the total amount of food you eat rather than when you eat it for these outcomes.