Browse the evidence

Testosterone treatment in older men with low testosterone improves hemoglobin levels and corrects anemia, regardless of the cause of anemia.

If you are an older man with confirmed low testosterone and anemia, testosterone therapy can significantly improve your hemoglobin levels and correct your anemia, regardless of the cause. The treatment involves daily application of a gel, with dose adjustments to keep levels in the normal range for young men. While long-term safety requires more data, this study found no increase in cardiovascular or prostate issues over one year.

Lorcaserin (10 mg twice daily) provides sustained weight loss without increasing the rate of major cardiovascular events compared to placebo in high-risk overweight or obese patients.

If you are overweight or obese and have heart disease or risk factors, taking lorcaserin (10mg twice daily) along with diet and exercise helps you lose more weight than diet and exercise alone, without increasing your risk of heart attack or stroke compared to just doing diet and exercise.

GLP-1 receptor agonists (GLP-1RAs) provide high glycemic efficacy and facilitate weight loss in type 2 diabetes without conferring a risk of hypoglycemia.

GLP-1 receptor agonists are injectable medications that effectively lower blood sugar and help with weight loss in type 2 diabetes without causing low blood sugar. They come in daily or weekly formulations. Side effects like nausea are common initially but often improve over time. They are particularly useful for patients who need to avoid weight gain or hypoglycemia associated with other diabetes medications like insulin or sulfonylureas.

Tirzepatide (5, 10, and 15 mg once-weekly) provides superior glycemic control (HbA1c reduction) and greater body weight loss compared to placebo, GLP-1 receptor agonists, and basal insulin in adults with type 2 diabetes.

Tirzepatide is a once-weekly injection that lowers blood sugar and helps with weight loss more effectively than existing GLP-1 drugs (like semaglutide) and basal insulin. It works by mimicking two gut hormones (GIP and GLP-1). While it is very effective, it can cause stomach issues like nausea and diarrhea, which might lead some people to stop taking it, especially at higher doses. It does not increase the risk of low blood sugar (hypoglycemia) on its own.

Semaglutide 2.4 mg administered subcutaneously once weekly reduces major adverse cardiovascular events (MACE) in patients with established cardiovascular disease and overweight or obesity, independent of diabetes status.

If you have established heart disease and are overweight or obese, but do not have diabetes, semaglutide 2.4 mg once weekly is a treatment option being tested to reduce your risk of heart attack, stroke, or cardiovascular death. It is taken as a weekly injection, started at a low dose to minimize stomach side effects, and used alongside standard heart health care. This approach targets obesity as a direct cause of cardiovascular risk, independent of blood sugar levels.

Semaglutide 2.4 mg once weekly improves symptoms, exercise capacity, and reduces inflammation in patients with obesity-phenotype heart failure with preserved ejection fraction (HFpEF) across all obesity classes (BMI 30-34.9, 35-39.9, and ≥40 kg/m²), with clinical benefits directly proportional to the magnitude of weight loss.

If you have heart failure with preserved ejection fraction and obesity, semaglutide (2.4 mg weekly) is a proven treatment that improves your heart symptoms, exercise ability, and inflammation. The more weight you lose, the more you benefit, regardless of whether your obesity is Class I, II, or III. This treatment works best when combined with a moderate caloric deficit (500 kcal/day) and regular physical activity.

Pharmacotherapy is recommended for postmenopausal females and males aged 50+ who have had a previous hip or vertebral fracture, or have a 10-year major osteoporotic fracture risk of 20% or more.

If you are over 50 and have had a hip or vertebral fracture, or have a high 10-year fracture risk (20% or more), you should strongly consider pharmacotherapy. This is a strong recommendation based on high-certainty evidence. Your doctor will help you choose the right medication based on your specific risks and preferences.

Aerobic exercise training significantly improves insulin resistance (HOMA-IR) and fasting serum glucose levels in individuals with Type II Diabetes.

Regular aerobic exercise directly improves how your body uses insulin and lowers your fasting blood glucose levels. This is a key benefit of exercise for managing Type II Diabetes, alongside improving overall fitness and HbA1c.

Liraglutide (3.0 mg daily) is effective for weight loss but significantly less so than Semaglutide, with a mean weight loss of 6.4% compared to 15.8%.

Liraglutide (3.0 mg daily) is an FDA-approved option for weight loss, but it produces roughly half the weight loss of Semaglutide (6.4% vs 15.8%). It requires daily injections, which may be burdensome, and you must reach the 3.0 mg dose to see full effects. If you cannot tolerate Semaglutide, this is a viable alternative, but expect less dramatic results.

Certain anti-diabetic medications, specifically insulin, can increase body weight, creating a conflict in treating obesity and T2DM simultaneously.

If you are prescribed insulin for diabetes, be aware it can cause weight gain. Discuss weight-neutral or weight-loss promoting alternatives (like GLP-1 agonists or SGLT2 inhibitors, though not explicitly named here, implied by 'anti-obesity drugs') with your doctor if weight management is a priority.

Once-weekly semaglutide (2.4 mg) significantly improves heart failure symptoms, physical limitations, and exercise capacity in patients with obesity-related heart failure with preserved ejection fraction (HFpEF) and type 2 diabetes, independent of the magnitude of weight loss.

If you have heart failure with preserved ejection fraction, are obese, and have type 2 diabetes, once-weekly semaglutide (2.4 mg) can significantly reduce your heart failure symptoms and help you lose weight. This treatment works even if your weight loss isn't as dramatic as in people without diabetes, suggesting it helps your heart directly. It is administered as a weekly injection, starting at a low dose to minimize side effects, and titrated up over 16 weeks.

GLP-1 receptor agonists delay gastric emptying, which reduces postprandial lipid and carbohydrate surges and contributes to satiety.

GLP-1 medications slow down how fast food leaves your stomach. This helps you feel full longer and prevents sharp spikes in blood sugar after meals.

GLP-1 receptor agonists reduce the risk of major adverse cardiovascular events (MACE), death, and stroke in patients with type 2 diabetes.

If you have type 2 diabetes, GLP-1 receptor agonists can significantly lower your risk of heart attacks, strokes, and death. This benefit is independent of weight loss and is supported by large-scale data involving over 60,000 patients.

GLP-1 receptor agonists (GLP-1RAs) promote sustained weight loss in adults with obesity or type 2 diabetes primarily by increasing energy expenditure and reducing food intake via central nervous system satiety signaling, independent of glycaemic control.

If you have obesity or Type 2 Diabetes, GLP-1 medications like semaglutide or liraglutide are proven to help you lose significant weight (around 15% in trials) by reducing hunger and increasing energy burn. They are taken as a weekly or daily injection, often alongside diet and exercise changes. These are not quick fixes but chronic treatments that mimic a natural gut hormone to help regulate your body's weight set-point.

Once-weekly subcutaneous semaglutide (2.4 mg) significantly alters the circulating proteome in individuals with obesity, downregulating proteins associated with cardiovascular disease risk and inflammatory pathways beyond what is explained by weight loss and glycemic control alone.

If you have obesity and are considering semaglutide, know that it does more than just help you lose weight. It actively changes your blood proteins to lower your risk of heart disease and inflammation, even independent of the weight you lose. This makes it a valuable tool for cardiovascular protection in high-risk individuals, not just a weight-loss aid. The benefits are supported by large, rigorous clinical trials.

Tirzepatide 15mg is associated with a higher rate of adverse events compared to other GLP-1RAs, although not significantly different from placebo in some metrics, it ranks highest in SUCRA for adverse events.

Tirzepatide 15mg is highly effective but comes with a higher risk of side effects like nausea and diarrhea compared to other GLP-1s. Patients should be prepared for this and work with their doctor on dose titration to manage it.

GLP-1 receptor agonists reduce the risk of Major Adverse Cardiovascular Events (MACE) by 13-26% in patients with type 2 diabetes and high cardiovascular risk.

If you have type 2 diabetes and heart disease or high heart risk, GLP-1 medications like semaglutide or liraglutide are recommended not just for blood sugar, but to protect your heart. Studies show they can lower the risk of heart attacks and strokes by 13-26% compared to placebo.

GLP-1 receptor agonists improve cardiovascular outcomes by reducing major adverse cardiovascular events (MACE), including cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke, in patients with type 2 diabetes and established cardiovascular disease.

If you have type 2 diabetes and existing heart disease, certain GLP-1 medications (like liraglutide, semaglutide, or dulaglutide) can significantly lower your risk of heart attack, stroke, or cardiovascular death. This benefit is independent of weight loss and is a key reason these drugs are recommended for high-risk patients.

Discontinuation of semaglutide treatment leads to significant weight regain, resulting in net weight loss that is substantially lower than the peak loss achieved during treatment.

If you stop taking semaglutide, you will likely regain most of the weight you lost. The net weight loss after stopping is much smaller than the peak loss. Long-term maintenance may require continued treatment.

GLP-1 receptor agonists (Liraglutide, Semaglutide) and Tirzepatide reduce food intake primarily by increasing satiety and reducing neural activation in brain areas associated with appetite and reward, rather than just delaying gastric emptying.

Semaglutide (2.4 mg weekly) works by acting on your brain to make you feel full sooner and reducing the desire for high-calorie foods. It is not just about stomach emptying. Start with a low dose to minimize side effects, titrating up to 2.4 mg over several months.

Incretin-based therapies improve cardiovascular risk factors (lipids, blood pressure) and reduce the risk of major cardiovascular events and heart failure in individuals with obesity.

For those with obesity, incretin therapies like semaglutide offer cardiovascular protection, lowering risks of heart events and heart failure, independent of just weight loss.

Thiazolidinediones (specifically Pioglitazone) significantly reduce cardiovascular events (stroke, MI, mortality) in patients with Type 2 Diabetes and macroangiopathies or recent stroke/TIA, independent of glucose lowering.

If you have Type 2 Diabetes and a history of stroke, heart attack, or significant blood vessel disease, ask your doctor about Pioglitazone. It is one of the few diabetes medications proven to significantly reduce the risk of another stroke or heart attack, even in people who do not have diabetes but have insulin resistance. While it can cause side effects like swelling, these are often manageable, and the cardiovascular protection can be life-saving.

GLP-1 receptor agonists (e.g., Liraglutide) and SGLT2 inhibitors (e.g., Empagliflozin) reduce cardiovascular mortality in Type 2 Diabetes patients, primarily through mechanisms involving insulin sensitivity and weight loss rather than direct glucose lowering.

If you have Type 2 Diabetes and are at high risk for heart problems, medications like Liraglutide (a GLP-1 agonist) or Empagliflozin (an SGLT2 inhibitor) can significantly reduce your risk of dying from cardiovascular causes. These drugs work not just by lowering blood sugar, but by improving how your body uses insulin and promoting weight loss. Discuss these options with your doctor, especially if you have existing heart disease.

Subcutaneous semaglutide increases the risk of gastrointestinal adverse events (nausea, diarrhea, vomiting) compared to placebo and other antidiabetic agents, but does not increase the risk of serious adverse events, hypoglycemia, acute pancreatitis, or diabetic retinopathy.

While semaglutide is effective, be aware that it commonly causes nausea, diarrhea, or vomiting, especially when starting or increasing the dose. These side effects are usually mild and temporary. Importantly, it does not appear to increase the risk of serious conditions like pancreatitis, hypoglycemia, or eye problems compared to other treatments.