Browse the evidence

A high-carbohydrate diet (60% of energy) lowers maximal adipose tissue mitochondrial respiration compared to moderate (40%) or low (20%) carbohydrate diets, potentially favoring fat storage over oxidation.

This research suggests that eating a diet very high in carbohydrates (60% of calories) might slow down how efficiently your fat cells burn energy, potentially making it easier to store fat. However, this was a small study in people who had already lost weight. It does not mean you should avoid carbs, but it hints that diet composition matters for how your body handles fuel, not just total calories.

GLP-1 receptor agonists (liraglutide, semaglutide, tirzepatide) administered as adjunct therapy to bariatric surgery significantly reduce BMI and total body weight in patients with insufficient weight loss or weight regain.

If you have had bariatric surgery but are not losing enough weight or are gaining it back, ask your doctor about adding a GLP-1 agonist (like semaglutide or tirzepatide) to your regimen. These medications, taken weekly or daily, have been shown to significantly boost weight loss and improve metabolic health (blood sugar, blood pressure) in this specific group. Be prepared for potential mild stomach issues, which usually subside, and discuss cost coverage with your provider.

GLP-1 receptor agonists improve metabolic outcomes, including glycemic control, blood pressure, and lipid profiles, in post-bariatric surgery patients.

Beyond weight loss, GLP-1 agonists can help normalize blood sugar, lower blood pressure, and improve cholesterol levels in patients who have had bariatric surgery. This makes them a valuable tool for managing overall metabolic health, not just weight.

GLP-1 receptor agonists (e.g., semaglutide, tirzepatide) show promising results for MASH resolution and weight loss, though phase 3 histological data is still emerging.

GLP-1 agonists like semaglutide and tirzepatide are showing strong promise for resolving MASH and reducing liver fibrosis, especially in those with obesity or diabetes. While not yet universally endorsed for MASH alone, they are beneficial for comorbidities.

For individuals with type 2 diabetes on single non-insulin medication, the maximum justifiable cost for a weight loss maintenance intervention is lower (£88.14) than for those with high BMI alone (£104.64) at an ICER of £20,000 per QALY.

For a person with type 2 diabetes on medication, a weight loss maintenance program is considered cost-effective if it costs less than approximately £88 per person. This is a lower threshold than for non-diabetics because the potential for long-term health gains (QALYs) is smaller for those who already have the disease.

Combination therapy of Cagrilintide (amylin analogue) and Semaglutide (GLP-1 agonist) produces synergistic weight loss, with the 2.4 mg Cagrilintide dose achieving 17.1% weight loss over 20 weeks.

Combining Cagrilintide (an amylin analogue) with Semaglutide (a GLP-1 agonist) in a 20-week trial led to an average 17.1% weight loss, significantly better than Semaglutide alone (9.8%). This combination targets multiple hormonal pathways to suppress appetite. It is currently in Phase 1 development, and side effects were mostly mild gastrointestinal issues.

Oral semaglutide 14 mg daily produces clinically significant weight loss (≥5%) in approximately half of non-diabetic obese adults, with an average loss of 5.7% and a favorable safety profile, though it is less effective than injectable semaglutide or tirzepatide.

If you are obese and do not have diabetes, taking 14mg of oral semaglutide daily for a year will likely result in about 6% body weight loss on average. While not as powerful as the injectable version, it is a safe option if you dislike injections or cannot access injectable medications. Expect mild nausea in some cases, but serious side effects are rare.

Switching from GLP-1 receptor agonists (dulaglutide or semaglutide) to tirzepatide for six months significantly reduces body weight, HbA1c, and markers of metabolic dysfunction-associated steatotic liver disease (MASLD) including the fatty liver index and FIB-4 index in patients with type 2 diabetes.

For patients with Type 2 Diabetes and fatty liver disease currently on GLP-1 RAs like dulaglutide or semaglutide, switching to tirzepatide (starting at 2.5mg weekly, increasing to 5mg after 4 weeks) for six months can lead to significant weight loss, improved blood sugar control, and reduced liver fat and fibrosis markers. This benefit persists even if the patient was previously on semaglutide, though appetite suppression may be less pronounced in that subgroup.

GLP1:Gcg dual agonists (Mazdutide and Cotadutide) show promise in weight loss and glycemic control, with additional benefits for Non-Alcoholic Fatty Liver Disease (NAFLD) and Non-Alcoholic Steatohepatitis (NASH).

GLP1:Gcg dual agonists like Mazdutide and Cotadutide show significant weight loss and glycemic benefits, with additional advantages for liver health in NAFLD/NASH patients. Mazdutide showed 11.7% weight loss in 12 weeks, while Cotadutide showed weight loss comparable to Liraglutide over 54 weeks. These therapies are promising but still under investigation.

HDL functionality (cholesterol efflux capacity) and proteomic composition are better predictors of CVD risk than static HDL cholesterol levels, and these functional properties are negatively impacted by SFA-enriched diets compared to MUFA-enriched diets.

Don't just focus on raising your HDL number. Focus on eating healthy fats (like MUFA) rather than excessive saturated fats, as this may improve the *function* of your HDL (how well it clears cholesterol) and reduce inflammation. This is an emerging area of science.

Dual and triple receptor agonists (Tirzepatide, Survodutide, Retatrutide) show promise in MASH resolution, with some demonstrating superior efficacy to single GLP-1 agonists in weight loss and MASH resolution, though long-term hepatic outcomes are still being established.

Newer multi-agonist drugs like Tirzepatide (5-15mg weekly) show strong results in resolving MASH and improving fibrosis in Phase 2 trials, often matching or exceeding the efficacy of single GLP-1 agonists. Patients should discuss access and cost with their providers, as these are newer, expensive therapies with robust but still maturing long-term data.

Semaglutide produces greater weight loss than liraglutide but is associated with more intense gastrointestinal adverse effects, particularly nausea and vomiting.

If you are choosing between semaglutide and liraglutide for weight loss, expect semaglutide to deliver better results but with more intense stomach issues like nausea and vomiting. These side effects are usually mild or moderate and tend to decrease over time. If you have a sensitive stomach, liraglutide might be better tolerated, but you may lose less weight.

GLP-1 receptor agonists (liraglutide and exenatide) produce significant weight loss and BMI reduction in women with PCOS, alongside improvements in metabolic and cardiovascular risk markers.

For women with PCOS and obesity, GLP-1 agonists like liraglutide and exenatide are effective for weight loss and improving metabolic health. Treatment involves starting at a low dose to manage side effects like nausea, then titrating up to the therapeutic dose (1.8mg for Liraglutide, 10mcg BID for Exenatide) over several weeks. This should be combined with lifestyle changes.

GLP-1 receptor agonists improve reproductive outcomes in women with PCOS, including increased menstrual regularity and spontaneous pregnancy rates, by reducing androgen levels and improving insulin resistance.

If you have PCOS and are struggling with irregular periods or infertility, GLP-1 agonists may help regulate your cycle and increase your chances of natural pregnancy by lowering testosterone and improving insulin sensitivity. However, these medications should be stopped before trying to conceive, and their safety during pregnancy is still being studied.

GLP-1 receptor agonists improve cardiovascular risk markers in women with PCOS, including reductions in inflammatory markers (CRP) and improvements in endothelial function, although effects on lipid profiles are inconsistent.

GLP-1 agonists can improve your heart health by reducing inflammation and improving blood vessel function, which is important for PCOS patients. However, they may not consistently lower cholesterol levels, so monitoring other cardiovascular risk factors is also important.

GLP-1 receptor agonists (GLP-1RAs) reduce systemic inflammation and improve metabolic parameters in patients with psoriatic disease (PsD) and its comorbidities (obesity, T2DM, cardiovascular disease).

If you have psoriasis or psoriatic arthritis along with obesity or type 2 diabetes, GLP-1 receptor agonists (like semaglutide or liraglutide) can help manage both your metabolic health and inflammation. These drugs not only promote significant weight loss but also reduce key inflammatory markers (TNF, IL-6) linked to psoriatic disease severity. While they are primarily known for diabetes and weight management, emerging evidence suggests they may also improve joint and skin symptoms, especially in patients who are obese. Consult your rheumatologist to see if adding a GLP-1RA to your current treatment plan is appropriate.

Semaglutide administration (up to 1.0 mg/week) in obese heart failure patients significantly reduces BMI and improves functional capacity (NYHA class and 6-minute walk distance) compared to standard medical therapy alone.

For obese heart failure patients, adding semaglutide to standard care can significantly reduce weight and improve heart failure symptoms and walking distance. The medication is taken once weekly, starting at a low dose to minimize nausea, and titrated up over months. While not a cure, it offers a pharmacological option for weight management in this specific population where exercise may be limited by dyspnea.

Semaglutide treatment (1.7-2.4 mg weekly) in patients with hypothalamic obesity secondary to craniopharyngioma produces sustained, clinically significant weight loss (median 16%) and improves metabolic biomarkers (HbA1c, LDL) over 24 months.

For patients with hypothalamic obesity, semaglutide (1.7-2.4 mg weekly) is an effective long-term treatment for weight loss and metabolic health. It is crucial to maintain consistent dosing, as interruptions can lead to fat mass regain. Side effects are generally mild and manageable.

Multi-modal anti-obesity medication (mmAOM) therapy yields significantly greater preoperative percent total body weight loss (%TBWL) than GLP-1 receptor agonist monotherapy or non-pharmacologic medically supervised weight loss in patients with BMI ≥ 70 kg/m².

If you have a BMI of 70 or higher and are preparing for weight loss surgery, combining multiple weight loss medications (mmAOM) under medical supervision leads to significantly more weight loss than using just one GLP-1 medication or lifestyle changes alone. This approach helps reduce surgical risks. Discuss with your doctor if a combination therapy is appropriate for your insurance coverage and health profile.

Adding a GLP-1 agonist (oral semaglutide) to SGLT2 inhibitor therapy in patients with T2DM and NAFLD who have experienced SGLT2I rebound or failure significantly improves visceral adipose tissue index (VATI), subcutaneous adipose tissue index (SATI), and glycemic control (HbA1c).

If you have Type 2 Diabetes and fatty liver, and your current SGLT2 inhibitor medication (like luseogliflozin) stops working or your liver enzymes/blood sugar start to worsen, adding a GLP-1 agonist (like oral semaglutide) can significantly help reduce visceral and subcutaneous fat and improve blood sugar control. This strategy is specifically for those who do not respond well to SGLT2 inhibitors alone.

Weekly subcutaneous semaglutide (up to 2.4 mg) reduces BMI, HbA1c, and blood pressure, and improves self-rated quality of life in patients with schizophrenia or schizoaffective disorder and obesity.

For patients with schizophrenia or schizoaffective disorder and obesity, weekly semaglutide injections (up to 2.4 mg) can effectively reduce weight, improve blood sugar control, and lower blood pressure, while also improving quality of life. This treatment is feasible in inpatient settings, even for those with severe mental illness, though side effects like nausea may lead some to discontinue. It should be considered as part of a comprehensive care plan including dietary advice.

Yoga interventions significantly reduce serum leptin levels and increase serum adiponectin levels in individuals with obesity or metabolic syndrome.

If you have obesity or metabolic syndrome, incorporating yoga into your routine may help improve your hormonal balance by lowering leptin (which drives hunger) and raising adiponectin (which fights inflammation). For best results, look for programs that combine yoga with dietary changes, as the hormonal benefits appear stronger when diet is also addressed.

Qingre Lishi decoction, when combined with lifestyle intervention, significantly improves glycemic control (FPG, 2hPG, eHbA1c) and reduces glycemic variability (TIR, SD, CV) in newly diagnosed overweight/obese T2DM patients compared to lifestyle intervention alone.

For newly diagnosed obese T2DM patients, adding Qingre Lishi decoction (300ml daily split into 3 doses) to standard lifestyle changes (diet/exercise) significantly improves blood sugar stability and time-in-range compared to lifestyle changes alone. This herbal intervention was shown to be safe with fewer hypoglycemic events.

Adherence to a high-quality carbohydrate diet (high fiber, low glycemic index, high whole-grain ratio, high solid-to-liquid carbohydrate ratio) is associated with a significantly lower prevalence of metabolic syndrome, primarily driven by reduced hypertriglyceridemia.

To lower your risk of metabolic syndrome, focus on the quality of your carbohydrates rather than just cutting them out. Prioritize foods high in dietary fiber, whole grains, and those with a low glycemic index, while minimizing liquid carbohydrates like sugary drinks and refined grains. This shift specifically helps lower triglyceride levels, a key component of metabolic health.