Browse the evidence

Liraglutide was well-tolerated, with benefits experienced by over 90% of patients.

Liraglutide can be considered a safe option for obesity management in clinical practice.

Individuals without diabetes were more likely to achieve ≥10% weight loss compared to individuals with T2D (21.4% vs. 0%).

Practitioners may consider the likelihood of achieving significant weight loss when prescribing tirzepatide based on diabetes status.

There is a significant inverse association between the increasing number of nights worked in the 2 weeks preceding urine collection and urinary melatonin levels (r = −0.30, P = 0.008).

Practitioners should consider that recent night work may reduce melatonin levels in women.

Adhering to a hypercaloric, high-protein plant-based diet during resistance training preserves insulin sensitivity (HOMA-IR) and prevents the rise in fasting serum insulin seen with an isoenergetic, isonitrogenous omnivorous diet.

If you are eating enough protein (around 2g per kg of body weight) and training hard, choosing a plant-based diet rich in mycoprotein (like Quorn) can help keep your insulin sensitivity stable. You don't need to worry about the metabolic downsides often associated with high-protein diets, as long as you match the calories and protein of an omnivorous diet.

Elevated triglyceride levels and poor glycaemic control (HbA1c/T2DM) causally mediate the majority of the increased coronary heart disease (CHD) risk associated with higher body mass index (BMI).

For individuals with high BMI, simply losing weight may not be enough to protect the heart. The research indicates that high triglycerides and poor blood sugar control (HbA1c) are the main drivers of heart disease risk in this group. Therefore, secondary prevention should focus on actively managing these specific metabolic markers—through diet, medication, or lifestyle changes—rather than focusing solely on body weight or LDL cholesterol.

Higher BMI causally increases the risk of Coronary Heart Disease (CHD) independently of LDL cholesterol levels.

High body weight is a direct cause of heart disease risk, but not through the traditional LDL cholesterol pathway. This means that standard lipid-lowering strategies might not fully address the risk in obese individuals unless metabolic health (sugar and triglycerides) is also improved.

Obesity increases the risk of nephrolithiasis (kidney stones) through multiple mechanisms including lower urine pH, increased urinary oxalate, uric acid, sodium, and phosphate excretion, and insulin resistance-induced acidic urine.

If you are overweight, you are at higher risk for kidney stones due to changes in your urine chemistry caused by insulin resistance and diet. To reduce this risk, focus on weight management and a balanced diet that isn't excessively high in protein or sodium. Be aware that some surgical weight loss procedures can actually increase stone risk, so discuss this with your doctor.

Obesity is a significant risk factor for kidney stones (nephrolithiasis) and kidney cancer, driven by metabolic changes such as acidic urine and insulin resistance.

Being overweight increases your risk of kidney stones and kidney cancer. This is partly because obesity changes your urine chemistry, making it more acidic and prone to forming stones. Maintaining a healthy weight helps normalize urine chemistry and reduces these risks.

Tirzepatide improves cardiovascular risk factors, including blood pressure, lipid profiles, and liver fat content, in patients with type 2 diabetes, without increasing the risk of major adverse cardiovascular events in high-risk patients.

Tirzepatide not only lowers blood sugar and helps with weight loss but also improves other heart health markers like blood pressure, cholesterol, and liver fat. For patients with type 2 diabetes who are at high risk for heart problems, tirzepatide has not been shown to increase the risk of major cardiovascular events. This makes it a valuable option for comprehensive diabetes management, addressing both metabolic and cardiovascular health.

Sleep duration has a non-linear (L-shaped or U-shaped) relationship with MACE subtypes, with optimal benefits for heart failure but potential risks for myocardial infarction and stroke at longer durations.

While getting enough sleep (8-9.5 hours) is generally beneficial for heart health, be aware that the relationship between sleep duration and specific heart conditions varies. For heart failure, more sleep is linearly beneficial. For heart attacks and strokes, very long sleep durations might not offer additional benefits and could potentially be linked to other risks. Aim for the 8-9.5 hour range as a general guideline.

In males with type 2 diabetes, higher baseline endogenous total testosterone and lower estradiol levels significantly enhance the reduction of triglycerides achieved through intensive lifestyle intervention.

If you are a man with type 2 diabetes, your baseline testosterone and estradiol levels may dictate how effectively your diet and exercise efforts lower triglycerides. Men with higher testosterone and lower estradiol tend to see bigger improvements in triglycerides from lifestyle changes. This suggests that knowing your hormone profile could help tailor your lifestyle prescription for better lipid outcomes.

In females with type 2 diabetes, higher baseline sex hormone-binding globulin (SHBG) significantly enhances the reduction of LDL cholesterol achieved through intensive lifestyle intervention.

If you are a postmenopausal woman with type 2 diabetes, your baseline SHBG levels may dictate how effectively your diet and exercise efforts lower LDL cholesterol. Women with higher SHBG tend to see bigger improvements in LDL-C from lifestyle changes. This suggests that knowing your hormone profile could help tailor your lifestyle prescription for better lipid outcomes.

Higher baseline total testosterone predicts greater long-term weight loss and waist circumference reduction in both males and females with type 2 diabetes undergoing intensive lifestyle intervention.

If you have type 2 diabetes, your baseline testosterone levels may dictate how effectively your diet and exercise efforts lead to weight loss and waist circumference reduction. Both men and women with higher testosterone tend to see bigger improvements in weight and waist size from lifestyle changes. This suggests that knowing your hormone profile could help tailor your lifestyle prescription for better weight outcomes.

Metabolic bariatric surgery leads to sustained HbA1c reduction, whereas non-surgical management is associated with HbA1c increase in patients with type 2 diabetes.

For patients with severe obesity and type 2 diabetes, metabolic bariatric surgery offers significantly better long-term weight loss and blood sugar control than non-surgical management. While surgery is not for everyone, those who undergo it maintain much greater weight loss (22% vs 8.6%) and better glycemic control over five years. If surgery is not an option, intensive lifestyle modification and pharmacotherapy are critical alternatives to mitigate health risks.

Achieving comprehensive metabolic control (simultaneous HbA1c, LDL-C, and blood pressure targets) significantly reduces the risk of cardiovascular and microvascular complications in diabetic patients.

For diabetic patients, managing blood sugar, blood pressure, and cholesterol together is critical. Missing any one target leaves you at higher risk for heart and kidney damage. Work with your doctor to hit all three goals simultaneously, not just one.

Probiotic and synbiotic supplementation improves glycemic control, lipid profiles, and reduces inflammation in patients with type 2 diabetes and obesity, with strain-specific effects.

Taking specific probiotic or synbiotic supplements daily can modestly improve blood sugar and cholesterol levels in people with diabetes or obesity. Choose strains with clinical evidence (like Lactobacillus acidophilus or Bifidobacterium lactis) and take them consistently for at least 12 weeks.

Visceral fat accumulation is a primary driver of cardiovascular disease in obesity, independent of BMI, through inflammatory and metabolic mechanisms.

Focus on reducing visceral fat through lifestyle changes, not just BMI. Even if your BMI is normal, high waist circumference indicates higher cardiovascular risk.

Emulsions containing liquid-state triacylglycerols that are stable against gastric acid result in slower gastric emptying, higher postprandial satiety hormones (PYY, GLP-1), lower hunger hormone (ghrelin), and greater subjective satiety compared to emulsions with crystalline droplets or acid-unstable emulsifiers.

If you consume a liquid fat emulsion that is stable in stomach acid (like certain commercial beverages or formulated foods), it may keep you fuller for longer and trigger better satiety hormones than fats that crystallize or break down quickly in the stomach. Focus on the structure and stability of the fat, not just the calorie count.

The protective effect of beneficial dietary components on all-cause mortality is partially mediated by a reduction in systemic inflammation, as measured by the Systemic Inflammation Index (SII).

While reducing inflammation is part of the benefit, it is not the whole story. The dietary components likely work through multiple pathways, including direct gut microbiome effects, not just lowering blood inflammation markers.

Voluntary muscle forces are the primary determinant of bone mass and structural adaptation, dominating over gravitational forces from body weight.

To build or maintain bone density, focus on exercises that generate high muscle forces (like resistance training) rather than just weight-bearing activities. Muscle contraction is the primary signal for bone strengthening, not just gravity.

Mechanical loading can prevent or significantly reduce bone loss associated with estrogen deficiency, demonstrating that loading dominates bone balance.

Even after menopause, regular exercise can help prevent bone loss. It may not reverse all loss, but it is a powerful tool for maintaining bone density.

Acute exercise increases brain blood flow redistribution to areas controlling locomotor and vestibular functions, and long-term training is associated with higher cognitive performance and potentially larger brain size.

Exercise helps your brain by directing blood to active areas and promoting factors that support neuron health. Staying physically active is a key strategy for maintaining cognitive function as you age.

Obesity negatively impacts asthma outcomes and has a causal link in the pathogenesis of adult-onset asthma, primarily through a pro-inflammatory state driven by an imbalance in the adipose organ.

If you have obesity and asthma, your excess fat tissue is actively creating inflammation that makes your asthma worse. This is not just about being less active; it is a biological mechanism. Weight loss, even without surgery, can reduce this inflammation and improve asthma control.

Postprandial hyperglycemia and glycemic variability are more strongly correlated with cardiovascular disease and mortality than fasting hyperglycemia alone, and controlling postprandial excursions reduces oxidative stress and hypoglycemia risk.

Don't just focus on fasting numbers. Large spikes after meals cause oxidative stress and increase heart disease risk. Managing post-meal glucose is crucial for long-term health.