Browse the evidence

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.

Teneligliptin (20-40 mg/day) effectively lowers HbA1c over 6-12 months regardless of eating patterns (skipping meals or late dinners), though achieving HbA1c < 7.0% is less likely in patients with disrupted patterns.

Take Teneligliptin as prescribed (20-40mg daily). It will lower your blood sugar even if you skip meals or eat dinner late. However, to get your HbA1c below 7%, you should aim for regular meals and earlier dinners.

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.

High-intensity acute exercise suppresses hunger and food intake, whereas low-to-moderate intensity exercise does not significantly affect appetite or food intake.

If your goal is to suppress appetite immediately after working out, prioritize high-intensity exercise (above 60% VO2max). Low and moderate intensity workouts will not provide this appetite-suppressing effect and may even increase hunger.

Chronic exercise combined with weight loss increases circulating ghrelin levels and hunger, acting as a physiological mechanism to regain lost weight.

When you lose weight through exercise and diet, your body will naturally increase hunger hormones (ghrelin) to try to regain the weight. This is a normal physiological response. To maintain your weight loss, you must be prepared for increased hunger and adopt strategies to manage it, such as rearranging exercise intensity and duration.

Long-term semaglutide treatment (0.5–2 mg weekly) induces significant weight loss (up to 14.4%) and appetite suppression in Prader-Willi syndrome (PWS) patients without diabetes, though efficacy is variable and weight regain occurs upon discontinuation.

For PWS patients, semaglutide (0.5-2mg weekly) is a viable option for weight loss and appetite control, even after bariatric surgery. However, results vary, and stopping the drug leads to weight regain. It should be used as a long-term maintenance therapy alongside strict dietary controls, not as a one-time fix.

Short-term intensive insulin therapy improves beta-cell function and insulin sensitivity, increasing the likelihood of achieving type 2 diabetes remission compared to oral hypoglycemic agents alone.

For early-stage Type 2 Diabetes, short-term intensive insulin therapy can help restore your pancreas's ability to produce insulin. This approach is more effective for achieving remission than oral medications alone, though it requires strict adherence and monitoring during the intensive phase.

Once-weekly subcutaneous retatrutide significantly reduces body weight, BMI, and waist circumference in patients with overweight, obesity, and/or type 2 diabetes compared to placebo.

If you have obesity or type 2 diabetes, once-weekly retatrutide injections can lead to significant weight loss (averaging over 10 kg in these studies) and improved blood sugar control compared to no treatment. Be prepared for potential nausea or vomiting, which are common but usually not severe. The benefits are substantial, but the treatment requires adherence to a weekly injection schedule and dose escalation.

Retatrutide significantly improves glycemic control, including reductions in HbA1c, fasting glucose, and daily mean blood glucose, in patients with obesity and/or type 2 diabetes.

For those with type 2 diabetes or obesity, retatrutide helps lower blood sugar levels (HbA1c, fasting glucose) effectively. This is achieved through weekly injections that mimic natural hormones to regulate glucose. The benefit is particularly pronounced for those who already have diabetes.

Telemedicine-based health coaching improves insulin sensitivity (HOMA-IR) in obese, nondiabetic adults, whereas in-person coaching and no coaching do not show significant within-group improvements.

Telemedicine coaching can help improve insulin sensitivity in obese, nondiabetic individuals, potentially reducing diabetes risk, even if other blood markers like glucose and HbA1c do not change significantly in the short term.

Liraglutide is the only other anti-obesity medication that does not significantly differ in efficacy from phentermine for achieving ≥5% weight loss over 6 months.

Liraglutide (up to 3mg daily) is a viable alternative to phentermine for weight loss, showing similar efficacy in achieving 5% weight loss over 6 months when combined with lifestyle changes.

Naltrexone/bupropion, lorcaserin, and orlistat are significantly less effective than phentermine for achieving ≥5% weight loss over 6 months.

Naltrexone/bupropion, lorcaserin, and orlistat are less likely to produce significant weight loss (≥5%) compared to phentermine over 6 months when combined with lifestyle changes.

Completion of a 24-week milk-based low-energy liquid diet (LELD) in adults with severe obesity significantly reduces the leptin-to-adiponectin ratio (LAR), indicating decreased insulin resistance, with the magnitude of LAR reduction being proportional to the percentage of weight lost.

If you have severe obesity, a structured, low-calorie milk-based diet for 24 weeks can significantly improve your metabolic health markers, specifically by lowering the ratio of leptin to adiponectin, which indicates better insulin sensitivity. This improvement is directly tied to how much weight you lose. However, be aware that adherence is difficult, with high dropout rates, and long-term weight maintenance is not guaranteed, so this intervention should be viewed as a powerful metabolic reset rather than a permanent lifestyle solution.

The same 12-week program significantly improves metabolic health markers, including insulin resistance (HOMA index), lipid profiles (triglycerides, VLDL), and inflammatory markers (CRP, PINI), independent of the magnitude of weight loss.

Obesity management should target metabolic health, not just weight. This program improves insulin sensitivity, lowers bad fats (triglycerides/VLDL), and reduces inflammation, which are key risk factors for cardiovascular disease and diabetes.

Time-restricted eating (TRE) improves metabolic markers (insulin sensitivity, blood pressure) and aids weight loss, but its long-term efficacy is not yet fully established.

Try eating within an 8-hour window each day (e.g., 12 PM to 8 PM). This may improve your blood pressure and insulin sensitivity. Be cautious if you have diabetes or are pregnant. Adjust the window to fit your social life.

An 8-week stress management program comprising diaphragmatic breathing, progressive muscle relaxation, and guided visualization significantly enhances weight loss (BMI reduction) and improves mental health outcomes in adults with obesity compared to standard lifestyle instructions alone.

If you are struggling with obesity, adding a structured stress management routine to your standard diet and exercise plan may yield better weight loss results than diet and exercise alone. The study used an 8-week program involving breathing exercises, muscle relaxation, and visualization, practiced weekly with home reinforcement. This approach targets the hormonal and behavioral links between stress and weight gain, such as cortisol-driven abdominal fat storage and emotional eating.

High-glycemic load carbohydrates promote obesity by stimulating insulin secretion, which partitions calories into adipose tissue, thereby reducing circulating fuel availability, increasing hunger, and lowering energy expenditure.

To manage weight, prioritize the quality of carbohydrates over strict calorie counting. Reduce intake of high-glycemic foods like refined grains, potatoes, and added sugars. Instead, emphasize low-glycemic carbohydrates such as non-starchy vegetables, legumes, and whole fruits. This approach aims to lower insulin levels, reduce fat storage, and decrease hunger, making it easier to maintain a healthy weight without severe restriction.

Individuals with high insulin secretion in response to carbohydrates are more likely to gain weight on high-glycemic load diets and benefit more from low-glycemic or low-carbohydrate diets.

If you struggle with weight loss despite following a low-fat diet, you might have a high insulin response to carbohydrates. Trying a low-glycemic or low-carbohydrate diet may be more effective for you.

People with severe insulin resistance or diabetes may benefit from reducing total carbohydrate intake.

If you have diabetes or severe insulin resistance, talk to your doctor about reducing your total carbohydrate intake. This may help improve your metabolic health, but long-term data is still being gathered.

Administration of 4 g daily of omega-3 carboxylic acids (Epanova) to statin-treated high-risk patients with hypertriglyceridemia and low HDL-C reduces triglycerides by 26-31% and non-HDL-C, but its impact on reducing cardiovascular events is currently unknown and being tested in the STRENGTH trial.

If you are on a statin and still have high triglycerides and low HDL, your cardiovascular risk remains elevated. This trial investigates whether adding 4 grams of a specific prescription omega-3 (Epanova) daily, on top of your statin, can lower those lipids and prevent heart events. While it reliably lowers triglycerides, whether this translates to fewer heart attacks or strokes is still being determined by the STRENGTH trial results.