Browse the evidence

Orlistat is effective in promoting weight loss in patients who have undergone Laparoscopic Adjustable Gastric Banding (LAGB) and have plateaued, but its use is not recommended after malabsorptive surgeries.

If you had gastric banding and your weight loss has stopped, Orlistat might help. It is an oral pill taken with meals that blocks fat absorption. It can lead to significant weight loss, but you must strictly limit fat in your diet to avoid unpleasant gastrointestinal side effects like diarrhea. It is not suitable for patients who had malabsorptive surgery.

In BDNF rs10835211 GG genotype carriers, higher daily energy intake (>1800 kcal) is associated with lower fasting insulin, lower HbA1c, and lower HOMA-IR compared to lower energy intake, despite similar or higher body weight.

If you carry the BDNF rs10835211 GG genotype, restricting calories too severely (<1800 kcal) might be associated with higher insulin resistance and HbA1c. Ensure you are eating enough to support your metabolic health, as this group may respond differently to caloric restriction.

Intensive Weight Management Programmes (IWMPs) utilizing Total Diet Replacement (TDR) achieve substantial, sustained weight loss (5-15%) and metabolic improvements in populations with obesity and type 2 diabetes, though specific evidence for women with PCOS is currently insufficient.

For women with PCOS, standard diet and exercise advice often fails to produce lasting metabolic benefits. Intensive programs using meal replacements (TDR) for a few months, followed by a structured return to food, can produce significant weight loss (5-15%) and improve metabolic health. However, because specific studies on PCOS are lacking, this approach should be considered promising but unproven for this specific group, requiring careful monitoring.

Both ketogenic-like (KLD) and ultra low-fat (ULF) diets produce similar weight loss and improvements in insulin resistance when adhered to, regardless of macronutrient composition.

You can lose significant weight and improve insulin resistance on either a very low-carb or a very low-fat diet, provided you stick to it. The specific macronutrient ratio matters less than your ability to maintain the diet and create a caloric deficit. Choose the pattern that allows you to minimize added sugars and refined grains while maximizing vegetables.

SANA (a nitroalkene derivative of salicylate) promotes weight loss and improves glucose management in humans through creatine-dependent thermogenesis, independent of UCP1 and AMPK.

SANA is an experimental drug that appears to trigger weight loss by increasing energy expenditure through creatine-dependent thermogenesis, rather than by suppressing appetite or increasing physical activity. In early human trials, doses of 200-400mg daily led to weight loss and improved glucose control within two weeks with a good safety profile. It works independently of the traditional UCP1 pathway, offering a potential alternative for those who do not respond to other mechanisms. Consult a physician for clinical trials or future availability.

Caloric restriction (CR) and fasting improve cardiac health and mitigate heart failure with preserved ejection fraction (HFpEF) by inducing autophagy, mitophagy, and reducing systemic inflammation.

For HFpEF patients, caloric restriction and fasting regimens (like intermittent fasting) can improve heart function and reduce inflammation. However, these diets are hard to stick to long-term and may cause side effects like muscle loss in some older adults. Because of these challenges, doctors are exploring medications that mimic these benefits without requiring strict dieting.

Caloric restriction mimetics (CRMs) such as SGLT2 inhibitors, GLP-1 agonists, and specific compounds like spermidine and rapamycin can replicate the beneficial effects of caloric restriction on HFpEF without requiring dietary restriction.

If you have HFpEF and struggle with strict dieting, ask your doctor about medications that mimic the effects of fasting. Drugs like SGLT2 inhibitors and GLP-1 agonists, as well as emerging compounds, may help improve heart function and reduce inflammation without requiring you to eat significantly less.

Female powerlifters are more likely than males to restrict energy intake and diet for body composition reasons during competition preparation and competition phases.

Female powerlifters should be aware that they are statistically more likely to restrict energy for body composition. Ensure that caloric restriction does not lead to Low Energy Availability (LEA), which can impair reproductive and skeletal health. Monitor energy intake relative to fat-free mass (aiming for >30-45 kcal/kg FFM/day depending on phase).

Powerlifters increase energy intake on hard training days but do not reduce intake on easier/rest days, prioritizing recovery and muscle growth over caloric deficit on low-volume days.

On easy or rest days, do not automatically slash your calories. Most powerlifters maintain intake to support muscle recovery and growth. Only reduce calories if your specific goal is fat loss and you are managing the deficit carefully, but prioritize recovery needs.

Faster rates of body mass gain may slightly enhance hypertrophy in muscles receiving the greatest training stimulus (e.g., biceps brachii), although the evidence is weak.

While larger surpluses generally lead to more fat gain, if you are heavily training a specific muscle (like biceps), a slightly faster weight gain might offer a marginal hypertrophy benefit. However, this effect is weak and likely outweighed by the fat gain.

Low energy availability (energy deficit) following ACL injury can impair skeletal muscle hypertrophy and recovery, as the body may not have sufficient energy to support both healing and muscle growth.

After ACL surgery, avoid cutting calories to 'stay lean.' Your body needs sufficient energy to heal and rebuild muscle. Focus on eating enough to support your activity level and recovery, rather than restricting food intake.

Female volleyball players are at high risk of Low Energy Availability (LEA), leading to negative health outcomes like menstrual dysfunction and bone loss.

Ensure you are eating enough to fuel your training. If you are feeling constantly tired, missing periods, or getting injured often, you might not be eating enough. Focus on balanced meals with enough carbohydrates, protein, and fats to support your activity level.

GLP-1 receptor agonists and GIP analogs show potential for achieving Type 2 diabetes remission through significant weight loss, but current trial data is limited.

For those with overweight or obesity, GLP-1 and GIP-based medications can facilitate significant weight loss, which is a key driver for Type 2 diabetes remission. While trials are still mapping their long-term efficacy for remission, they represent a promising tool for achieving weight loss goals necessary for reversing the disease.

Long-term dietary interventions (≥12 months) involving moderate macronutrients, low-fat/high-carbohydrate, or high-fat/low-carbohydrate diets all produce significant and comparable weight loss, BMI reduction, and waist circumference reduction compared to a usual diet, with no clinically significant difference between the specific diet types.

If you are overweight or obese, any structured diet that involves active counseling and reduces calories will help you lose weight over the long term (12+ months). Whether you choose high-fat, low-fat, or moderate macronutrients, the amount of weight lost is roughly the same (around 5 kg). Do not waste energy trying to find the 'magic' macronutrient ratio; instead, choose the dietary pattern that fits your lifestyle and preferences so you can stick with it.

Substituting low- and no-calorie sweetened beverages (LNCSB) for sugar-sweetened beverages (SSB) is associated with lower body weight and reduced risk of coronary heart disease, type 2 diabetes, and mortality, with effects comparable to substituting water for SSB.

If you currently drink sugar-sweetened beverages, switching to low- or no-calorie sweetened beverages (like diet soda or unsweetened iced tea) can help you lose a small amount of weight over time and may lower your risk of heart disease and type 2 diabetes. This benefit is similar to switching to water, making LNCSBs a viable, safe option for reducing sugar intake.

High-volume resistance training (>10 sets per muscle group) performed in a fasted state may benefit from acute carbohydrate supplementation compared to fasting or non-caloric placebo, likely due to glycogen sparing effects.

If you do a very high-volume leg or back session (e.g., 15+ sets) and you train fasted, consider eating carbohydrates before or during the workout. It will likely help you get more reps or sets. If you train fed, or do low volume, you don't need to worry about pre-workout carbs.

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.

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.

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.

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.