Browse the evidence

Maintaining a healthy body weight (BMI 20-25) is crucial for fertility, as both obesity (BMI >30) and underweight (BMI <20) are associated with delayed conception, ovulatory dysfunction, and reduced ART success rates.

Aim for a BMI between 20 and 25 if you are trying to conceive. Both being underweight and overweight can disrupt ovulation and reduce your chances of pregnancy. If you are overweight, even a modest weight loss (e.g., 5-10% of body weight) can significantly improve ovulation and fertility.

Liraglutide 3.0 mg significantly reduces Obstructive Sleep Apnea (OSA) severity, measured by Apnea-Hypopnea Index (AHI), in individuals with obesity and moderate-to-severe OSA who are unable or unwilling to use CPAP therapy.

If you have moderate to severe sleep apnea and obesity, and you can't or won't use a CPAP machine, ask your doctor about Liraglutide 3.0 mg. It is a once-daily injection that helps you lose weight and significantly reduces the number of times you stop breathing during sleep. The most common side effects are nausea and diarrhea, but these usually go away after a few weeks. It works best when combined with a healthy diet and exercise.

Canagliflozin (100 mg and 300 mg) significantly reduces HbA1c, body weight, and systolic blood pressure in patients with type 2 diabetes on background metformin compared to placebo and sitagliptin.

If you have type 2 diabetes and are already taking metformin, adding canagliflozin (100mg or 300mg daily) can significantly lower your blood sugar, help you lose weight, and reduce blood pressure compared to placebo or sitagliptin. While there is a slightly higher risk of genital yeast infections and urinary frequency, these are usually mild and rarely cause people to stop the medication. Hypoglycemia risk remains low.

Prescription omega-3s (4 g/d EPA-only) reduce major adverse cardiovascular events by 25% in high-risk patients with hypertriglyceridemia who are already taking statins.

If you are at high risk for heart disease and have high triglycerides, ask your doctor about adding prescription EPA-only omega-3s (like Vascepa) to your statin. The REDUCE-IT trial showed this combination reduced major heart events by 25% compared to placebo.

Dynamic aerobic endurance training significantly reduces resting and daytime ambulatory blood pressure in hypertensive patients, with effects mediated by reduced systemic vascular resistance and sympathetic tone.

Engage in moderate-intensity aerobic exercise (like brisk walking, jogging, or cycling) on most days of the week. You do not need to train for hours; sessions as short as 15-40 minutes are effective. Consistency matters more than extreme intensity. This is a primary, non-pharmacological treatment for lowering blood pressure.

Long-acting GLP-1 receptor agonists (dulaglutide, liraglutide, once-weekly exenatide) provide superior glycemic control (HbA1c and FPG reduction) compared to short-acting agents (EBID, lixisenatide) in type 2 diabetes patients.

If you have Type 2 Diabetes and need better blood sugar control, long-acting GLP-1 medications (like dulaglutide, liraglutide, or once-weekly exenatide) are more effective at lowering HbA1c and fasting glucose than short-acting versions (like twice-daily exenatide or lixisenatide). Choose a long-acting option for superior glycemic results, keeping in mind that all GLP-1s carry a risk of gastrointestinal side effects.

GLP-1 receptor agonists (e.g., exenatide, liraglutide, semaglutide) effectively treat type 2 diabetes and obesity by stimulating glucose-dependent insulin secretion, inhibiting glucagon secretion, slowing gastric emptying, and reducing appetite.

GLP-1 receptor agonists are a highly effective, FDA-approved class of medications for treating type 2 diabetes and obesity. They work by mimicking a natural gut hormone to increase insulin when blood sugar is high, decrease glucagon, slow digestion, and reduce appetite. While they can cause initial nausea, this is often manageable with slow dose increases. They offer the added benefit of cardiovascular protection for many patients.

Oral semaglutide at 7 mg/d and 14 mg/d, when added to metformin with or without sulfonylurea, significantly reduces glycated hemoglobin (HbA1c) and body weight compared to sitagliptin in adults with type 2 diabetes.

If you have type 2 diabetes that isn't well-controlled with metformin (with or without sulfonylurea), adding oral semaglutide at 7 mg or 14 mg daily can significantly lower your HbA1c and help you lose weight compared to taking sitagliptin. Start with 3 mg, then increase to 7 mg after 4 weeks, and finally to 14 mg after another 4 weeks. Take it first thing in the morning with water, at least 30 minutes before eating or taking other medications. The 3 mg dose alone is not effective for lowering HbA1c compared to sitagliptin, so sticking to the higher doses is important.

High-dose purified eicosapentaenoic acid (EPA) reduces major adverse cardiovascular events by 25% in high-risk patients with elevated triglycerides, an effect not observed with EPA/DHA combinations.

If you have high triglycerides and heart disease risk, ask your doctor about prescription EPA (icosapent ethyl). It has been proven to reduce heart attacks and strokes in people already taking statins, whereas standard fish oil supplements containing DHA have not shown the same benefit.

GLP-1 receptor agonists (GLP-1RA) provide superior glycemic control and weight loss compared to DPP-4 inhibitors in patients with type 2 diabetes, despite a higher incidence of gastrointestinal side effects.

If you have Type 2 Diabetes and are struggling with blood sugar and weight despite taking metformin, switching from a DPP-4 inhibitor (like sitagliptin) to a GLP-1 receptor agonist (like semaglutide or liraglutide) is likely to give you better blood sugar control and more weight loss. Be prepared for some initial stomach upset (nausea), which usually gets better over time. If you strongly dislike injections, ask about oral semaglutide, which offers similar benefits without needles.

Obesity, particularly abdominal obesity, exacerbates hyperandrogenism and insulin resistance in women with PCOS, leading to poorer reproductive outcomes (anovulation, infertility) compared to normal-weight women with PCOS.

If you have PCOS and are overweight, your excess body fat (especially around the abdomen) is actively making your hormonal imbalance worse. It lowers SHBG and raises insulin, which drives up androgens and stops ovulation. Losing weight reverses this hormonal drive, improving your chances of pregnancy and reducing metabolic risks like diabetes.

Chronic partial sleep restriction (4-5 hours/night) causes dysregulation of appetite hormones (lower leptin, higher ghrelin) and reduced insulin sensitivity, increasing the risk of obesity and type 2 diabetes.

Prioritize getting 7-9 hours of sleep per night. Chronic sleep restriction (less than 6 hours) directly alters your hunger hormones, making you hungrier and less sensitive to insulin, which significantly increases your risk of gaining weight and developing type 2 diabetes. Fixing your sleep schedule is a foundational step for metabolic health.

Administration of replacement-dose metreleptin (recombinant leptin) restores menstruation and normalizes neuroendocrine axes (gonadal, thyroid, adrenal, GH) in women with hypothalamic amenorrhea caused by chronic energy deficiency.

If you have hypothalamic amenorrhea due to over-exercising or undereating, standard estrogen therapy won't fix your fertility or bone health. This research shows that replacing the missing hormone leptin (via metreleptin injections) can restart your period and restore hormonal balance, even if you haven't gained weight yet. The treatment requires careful dose adjustment to prevent unwanted weight loss, but it addresses the root hormonal signal missing in your body.

Semaglutide 2.4 mg administered subcutaneously once weekly, used as an adjunct to lifestyle interventions, produces clinically significant weight loss in adults with obesity or overweight, with efficacy superior to the previously approved GLP-1 receptor agonist liraglutide.

If you have obesity or overweight and have struggled to lose weight with diet and exercise alone, adding semaglutide 2.4 mg (a once-weekly injection) to your lifestyle changes can lead to significantly greater weight loss than lifestyle changes alone. This medication works by mimicking a hormone that reduces hunger and increases fullness. It is most effective when combined with a modest calorie deficit and regular physical activity. Previous medications may not be as effective, and this treatment offers a more durable solution for weight management, including maintenance over time.

Leptin deficiency, whether genetic or acquired (e.g., lipodystrophy, hypothalamic amenorrhea), leads to severe metabolic and reproductive dysfunction, which can be reversed by leptin replacement therapy.

If you have very low body fat or a condition like lipodystrophy, your body may shut down non-essential functions like reproduction and metabolism because it thinks it is starving. Leptin therapy can reverse these effects, restoring fertility and metabolic health, even if you don't gain significant weight.

Testosterone treatment in older men with unequivocally low testosterone levels significantly improves sexual activity, libido, and erectile function.

If you are an older man with confirmed low testosterone and sexual concerns, testosterone therapy can significantly improve your sexual activity, desire, and erectile function. 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 prostate or heart issues over one year.

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.

High-intensity progressive resistance training (PRT) safely restores lean body mass and physical function in patients with established, stable rheumatoid arthritis (RA) without exacerbating disease activity.

If you have stable rheumatoid arthritis, high-intensity resistance training (lifting weights at about 80% of your max capacity) twice a week for 24 weeks is a safe and effective way to rebuild muscle and improve physical function. This approach does not worsen your disease activity or inflammation, contrary to older beliefs that RA patients are resistant to muscle building. You should consult your rheumatologist to ensure your disease is stable before starting.

Sleep restriction (4-5 hours per night) impairs glucose tolerance and insulin sensitivity, increasing the risk of type 2 diabetes and metabolic disorders.

Chronic sleep restriction impairs your body's ability to process glucose, increasing diabetes risk. Prioritize 7-8 hours of sleep to maintain healthy insulin sensitivity and glucose metabolism.

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.

The rate of starch digestion (RAG vs SAG) is a better predictor of postprandial glycemic response than total starch content, with Rapidly Available Glucose (RAG) being the main determinant of blood glucose spikes.

When eating starchy foods, choose those with higher Slowly Available Glucose (SAG) and lower Rapidly Available Glucose (RAG). This means choosing whole grains, pasta, or legumes over highly processed cereals or breads, as the latter cause sharper blood sugar spikes due to rapid starch digestion.