Browse the evidence

Medium-term resistance exercise training (7-23 weeks) significantly reduces fasted insulin and insulin resistance (HOMA-IR) in adults, whereas short-term and long-term effects are less consistent or non-significant.

If your goal is to improve insulin sensitivity, aim for 7-23 weeks of consistent resistance training (2-3 times per week). This duration window appears optimal for reducing fasting insulin and HOMA-IR scores.

Muscle-derived musclin (encoded by Ostn) is required for full endurance training adaptation, as its absence impairs training-induced improvements in running performance and mitochondrial activity.

Current evidence for musclin's role in training adaptation comes from short-term mouse studies. While it appears important for performance gains in mice, there is no human data yet. Do not seek out musclin-based interventions for training enhancement until human trials are available.

Focusing on caloric quantity rather than macronutrient quality (specifically rapidly absorbable carbohydrates) misdirects public health efforts and exacerbates obesity by ignoring metabolic and hormonal drivers.

Stop counting calories and start looking at food quality. Prioritize whole, minimally processed foods and avoid rapidly absorbable carbohydrates like sugar and refined starches. These foods drive hormonal changes that increase hunger and fat storage, making weight loss difficult regardless of portion size. Focus on eating foods that support metabolic health rather than trying to force weight loss through calorie restriction alone.

Traditional Chinese Medicine (TCM) interventions, including acupuncture, herbal medicine, and dietary therapy, may help manage obesity and diabetes by regulating gut microbiota, reducing inflammation, and improving insulin sensitivity.

If you are managing obesity or diabetes, TCM modalities like acupuncture, specific herbal formulas (e.g., Ginseng, Cinnamon), and dietary adjustments may offer supportive benefits by improving insulin sensitivity and gut health. However, these should not replace standard lifestyle changes or prescribed medications without consulting your doctor, as the evidence is still evolving.

Soy protein supplementation has an inconsistent effect on testosterone and cortisol levels, and more research is required to determine its impact on anabolic hormones.

Don't worry about soy protein affecting your hormones. The research shows inconsistent effects on testosterone and cortisol, with no clear evidence of negative impacts. You can consume soy protein without fear of hormonal disruption.

Newer GLP-1/GIP receptor agonists (semaglutide, tirzepatide) are expected to provide superior post-operative weight loss compared to prior GLP-1 RAs, despite a lack of specific post-surgical clinical trials.

Semaglutide and tirzepatide show impressive weight loss in non-surgical patients, but there is currently no data on their effectiveness specifically after bariatric surgery. Liraglutide and topiramate remain the best-supported options for post-surgical weight regain.

Off-label use of topiramate and/or metformin achieves clinically significant preoperative weight loss (>8% total body weight loss) in patients with BMI ≥50 kg/m2 who fail standard bariatric nutritional prescriptions due to dysregulated appetite.

If you have a BMI over 50 and are waiting for bariatric surgery but struggle with hunger and cravings despite dieting, ask your doctor about off-label use of generic Topiramate or Metformin. These drugs can help suppress appetite and facilitate the weight loss needed to make surgery safer and more successful, often at a fraction of the cost of newer branded drugs.

GLP-1 receptor agonists and GIP may influence cardiac lipid metabolism by modulating LPL activity, potentially offering cardioprotection, though the specific effect on cardiac LPL remains unclear.

GLP-1 and GIP drugs help with weight and glucose, but they may also directly affect how the heart processes fat. The exact impact on the heart is still being studied, but it may offer additional protection beyond weight loss.

Semaglutide treatment (up to 2.4 mg weekly) significantly reduces body weight, fat mass, and emotional eating behaviors in patients with hypothalamic obesity resulting from craniopharyngioma.

For patients with hypothalamic obesity due to brain tumors or surgery, semaglutide (up to 2.4 mg/week) combined with dietary counseling can significantly reduce weight and emotional eating, even when other treatments fail. It works by targeting brain circuits beyond the damaged hypothalamus.

Tirzepatide use in non-diabetic obese patients can induce severe ketoacidosis, primarily through starvation ketosis driven by gastrointestinal side effects and reduced caloric intake, rather than diabetic mechanisms.

If you are using tirzepatide for weight loss, do not buy it over the counter without medical oversight. Be aware that severe nausea, vomiting, or diarrhea combined with low food intake can lead to dangerous acid buildup (ketoacidosis), even if you do not have diabetes. Seek immediate medical attention if you experience abdominal pain, vomiting, and rapid breathing.

Tirzepatide use is associated with a risk of idiosyncratic acute liver injury, characterized by severe hepatotoxicity and coagulopathy, which resolves upon discontinuation of the drug.

If you are using tirzepatide for weight loss, do not skip liver function tests. While liver injury is rare, it can be severe and rapid. Report any persistent abdominal pain, vomiting, or yellowing of skin/eyes immediately. The drug should be stopped if liver enzymes rise significantly.

GLP1:GIP:Gcg triple agonists (SAR441255) show potential for weight loss and neurological benefits, including improved memory in mouse models of TBI and Alzheimer's disease.

GLP1:GIP:Gcg triple agonists like SAR441255 show potential for weight loss and neurological benefits, including improved memory in animal models of TBI and Alzheimer's disease. However, human data is preliminary, and glycemic benefits may be inferior to dual agonists. These therapies are in early development.

A healthy diet excluding cereal grains and dairy products improves glucose control in type 2 diabetes patients independently of macronutrient composition, fiber intake, glycemic load, and body weight changes.

If you have type 2 diabetes, try a healthy diet that excludes cereal grains and dairy products for at least 4 weeks. Ensure you eat enough to maintain your current weight and keep your protein, fat, and fiber intake similar to your usual healthy diet. Focus on fruits, vegetables, lean meats, fish, nuts, and eggs. This approach may improve your glucose control and hormonal balance (specifically glucagon) without needing to lose weight.

Tirzepatide use is associated with a probable risk of severe rhabdomyolysis and necrotising myopathy, potentially mediated by GLP-1 receptor effects on skeletal muscle glucose metabolism.

If you are taking tirzepatide (or similar GLP-1 drugs) and experience sudden, severe muscle pain, swelling, or weakness—especially if it doesn't match your activity level—seek medical attention immediately. Ask for a Creatine Kinase (CK) blood test. Stopping the medication and receiving IV fluids can resolve the condition, as seen in this case.

Ketogenic diets may offer unique metabolic benefits for cancer and neurodegenerative diseases through mechanisms like the Warburg effect and ketone utilization by the brain.

For individuals with cancer or neurodegenerative diseases like Alzheimer's, a ketogenic diet may offer metabolic benefits by targeting underlying insulin resistance and mitochondrial dysfunction. It is not a cure but may act synergistically with other treatments. Consult a healthcare provider before starting, as research is ongoing.

GLP-1 receptor agonists (GLP-1 RAs) improve skeletal muscle mitochondrial morphology, area, and number in animal models of obesity and type 2 diabetes, but their effect on mitochondrial respiration and mass is inconsistent or neutral.

Current evidence for GLP-1 RAs improving muscle mitochondria comes exclusively from animal and cell studies, not humans. While these studies show improved mitochondrial structure, they do not guarantee preserved muscle mass in people. To protect muscle while using GLP-1s for weight loss, prioritize resistance training and adequate protein intake, as the drug's direct benefit to human muscle mitochondria is not yet proven.

Increases in serum myostatin concentrations following resistance training are positively associated with gains in appendicular skeletal muscle mass in older adults, challenging the view that myostatin solely inhibits muscle growth.

Do not try to manipulate your myostatin levels. This study suggests that myostatin may actually increase as part of the muscle-building process in older adults. Focus on your training and nutrition; do not worry about serum myostatin levels as a barrier to growth.

Targeting hypothalamic AMPK in SF1 neurons using small extracellular vesicles (sEVs) loaded with dominant-negative AMPKα1 plasmids reduces body mass and adiposity by increasing sympathetic nervous system-mediated brown adipose tissue thermogenesis, without affecting food intake.

This technology is currently in preclinical stages (mouse models). While it shows promise for treating obesity by boosting energy expenditure rather than suppressing appetite, it is not yet available for human use. Current clinical options remain focused on lifestyle changes, bariatric surgery, and pharmacological agents like GLP-1 agonists.

Preclinical evidence suggests GLP-1 receptor agonists may offer cardioprotective benefits beyond weight loss, such as reducing fibrosis and inflammation, but this remains unproven in humans.

Current human trials show GLP-1 benefits are mostly due to weight loss. However, animal studies suggest the drug might also directly reduce heart inflammation and fibrosis. This potential direct benefit is not yet proven in humans, so patients should focus on the proven weight loss benefits while researchers investigate these additional mechanisms.

Combining extended dosing intervals (e.g., every two weeks) with increased dose sizes (e.g., doubling the mg strength) can maintain nearly 100% of the weight loss efficacy while halving the cost.

If you are on a lower dose of a GLP-1 drug (like 5mg tirzepatide) and find the weekly cost prohibitive, ask your doctor about switching to a higher dose (like 10mg or 15mg) taken every two weeks. This strategy can keep your weight loss results nearly identical to taking the lower dose weekly, but at half the cost. This is only possible if your body can handle the higher individual dose without excessive side effects.

Treatment with the dual GLP-1/GIP receptor agonist tirzepatide results in a proportional loss of skeletal muscle mass relative to total body weight, with muscle loss constituting approximately 34% of total weight loss in treated patients.

If you are taking tirzepatide, expect to lose some muscle along with fat. This case showed that about one-third of the weight lost was muscle. To counter this, you should prioritize strength training and ensure adequate protein intake, as suggested by the authors, rather than just focusing on the scale number.

Preclinical studies show conflicting results regarding GLP-1 agonists and breast cancer progression: some show inhibition of tumor growth via apoptosis, while others show promotion of growth in aggressive Triple-Negative Breast Cancer (TNBC) cell lines.

Animal studies show mixed results: GLP-1s might slow down some breast cancers but potentially speed up aggressive types (TNBC) in a lab setting. However, large human studies have not found an increased risk of developing breast cancer in people taking these drugs. If you have a history of breast cancer, discuss your specific subtype with your doctor.

Among patients taking oral semaglutide, older adults (65+) achieve significantly better weight loss outcomes than younger adults (<65).

If you are under 65 and taking the oral version of semaglutide, you might not lose as much weight as older patients on the same medication. If weight loss is your primary goal, the injection form is likely a better choice for you, as it provided superior results across all age groups in this study.

Tirzepatide treatment leads to significant weight loss in patients with hypothalamic obesity (HO) resulting from craniopharyngioma resection, despite the condition's historical resistance to standard therapies.

For patients with hypothalamic obesity due to brain tumors or surgery, standard diet and exercise often fail. Tirzepatide, a weekly injection starting at 2.5mg and increasing to 10mg, has shown significant weight loss in case reports. However, adherence is critical, as stopping the medication leads to rapid weight regain. Consult an endocrinologist to discuss if this treatment is appropriate for your specific condition.