Browse the evidence

MBS leads to marked improvements in sexual function for both men and women, including increased libido, erectile function, and hormonal normalization, typically within the first 12 months.

Expect significant improvements in sexual function and hormonal health within the first year after surgery. These changes are driven by weight loss and hormonal recalibration. Address any performance anxiety through counseling to maximize benefits.

GLP-1 receptor agonists (e.g., semaglutide) induce significant weight loss through hormonal mechanisms but carry a high risk of psychological dependency and rebound weight gain upon discontinuation, necessitating their use as temporary adjuncts to lifestyle interventions rather than standalone long-term solutions.

If you are using GLP-1 drugs, treat them as a temporary bridge to build sustainable habits, not a permanent solution. Prioritize resistance training and protein intake to protect muscle mass, as rapid weight loss without exercise increases frailty risk. Plan for discontinuation early by integrating behavioral therapy and dietary changes to prevent rebound weight gain and dependency.

Tirzepatide, a dual GLP-1/GIP receptor agonist, demonstrates significant efficacy in reducing body weight (over 20% in some cases) and improving glycemic control in patients with type 2 diabetes and obesity, suggesting therapeutic potential for women with Polycystic Ovary Syndrome (PCOS) who have comorbid obesity and insulin resistance.

For women with PCOS and obesity, tirzepatide offers a promising pharmacological tool to address both metabolic and reproductive symptoms. While not yet standard care for PCOS specifically, its ability to induce significant weight loss (>20%) and improve insulin sensitivity suggests it may help restore ovulation and reduce androgen levels. Treatment involves weekly subcutaneous injections starting at 2.5mg and titrating up to 15mg, ideally combined with lifestyle changes. Patients should be aware of potential GI side effects, though the drug's design aims to mitigate them.

GLP-1 agonists (semaglutide, tirzepatide) produce significant weight loss (15-21%) but are associated with isolated reports of depression and suicidal ideation, though causal links remain unproven.

GLP-1 medications like semaglutide and tirzepatide are highly effective for weight loss (15-21%), but require careful psychological monitoring. While serious mental health side effects are reported, they are isolated and not causally proven. You should undergo regular mental health check-ins alongside your medical treatment to ensure safety.

Naltrexone/Bupropion combination therapy offers good psychiatric tolerability with only mild, transient anxiety and insomnia, making it a safe alternative for patients concerned about mood stability.

Naltrexone/Bupropion is a well-tolerated weight loss option with a favorable psychiatric profile. While you may experience mild anxiety or insomnia initially, these do not typically progress to serious conditions. It is particularly suitable for patients with emotional eating patterns.

Pharmacological weight loss agents (GLP-1 agonists, etc.) should be used as adjuncts to lifestyle changes in older adults only after careful case-by-case assessment of sarcopenia risk and limited clinical data.

If lifestyle changes aren't enough, discuss prescription options like GLP-1 agonists with your doctor. Be aware that data for those over 75 is scarce, and these drugs can affect muscle mass, so they must be paired with strength training and protein intake.

GLP-1 receptor agonists reduce albuminuria and slow eGFR decline in non-diabetic patients with CKD, particularly those who are obese.

If you have kidney disease and are obese but do not have diabetes, ask your doctor about GLP-1 receptor agonists like semaglutide. Early evidence suggests these medications can significantly reduce albuminuria, a marker of kidney damage, even in non-diabetic patients. However, more research is needed to confirm long-term kidney outcomes in this group.

Preoperative GLP-1 RA therapy (4–8 weeks) reduces liver volume and visceral fat to improve surgical access, provided treatment is discontinued 1 week prior to surgery to mitigate aspiration risk.

If you are scheduled for bariatric surgery and take GLP-1 medications (like Ozempic or Wegovy), you must stop taking them at least one week before your operation. This is not optional; it is a safety requirement to prevent stomach contents from entering your lungs during anesthesia. The goal of this pre-surgery treatment is to shrink your liver and make the surgery technically easier and safer for the surgeon, not necessarily to prevent surgical complications like leaks.

Tirzepatide use in patients at increased risk of cardiovascular events does not increase the risk of serious adverse events or all-cause mortality compared to placebo, but significantly increases the risk of gastrointestinal non-serious adverse events.

If you are at high risk for heart issues, tirzepatide appears safe regarding serious complications like death or hospitalization, but you should expect stomach problems like nausea and diarrhea. These are common but usually not dangerous. Talk to your doctor about starting at a low dose to minimize these effects.

GLP-1/GIP agonists do not increase overall cancer risk and may reduce incidence of obesity-related cancers (endometrial, ovarian, gastrointestinal) via metabolic improvements, though organ-specific long-term safety remains uncertain.

GLP-1/GIP therapies are not associated with a general increase in cancer risk and may lower risk for obesity-related cancers. However, long-term organ-specific effects are not fully known, so standard cancer screening remains essential.

CJC-1295 and Ipamorelin restore youthful growth hormone secretion patterns by preserving physiological pulsatility, avoiding the adverse effects of continuous exogenous GH administration.

CJC-1295 and Ipamorelin are peptides that stimulate natural growth hormone pulses, potentially reversing age-related muscle loss and fat gain. While they show promise in restoring youthful GH patterns, they are not FDA-approved for anti-aging, and long-term safety data is lacking.

Treatment with tirzepatide is associated with numerically lower impairment in health-related quality of life (HRQoL) domains and work productivity compared to non-pharmacological management or other obesity medications in real-world settings.

If you are managing obesity with tirzepatide, you may experience better daily functioning and work productivity compared to managing it without medication, although individual results vary. This medication is typically taken once weekly alongside diet and exercise. Real-world data suggests these benefits are most pronounced when combined with weight loss.

Small-molecule oral GLP-1 receptor agonists (e.g., orforglipron) achieve glycemic and weight loss efficacy approaching that of established injectable peptide GLP-1RAs, offering a non-injectable alternative with comparable metabolic benefits.

If you struggle with injections or cold-chain storage, ask your doctor about oral small-molecule GLP-1RAs (like orforglipron). Recent trials show they can lower blood sugar and reduce weight significantly, often approaching the results of injectable drugs. Because they are taken daily, consistency is key, and starting with a low dose to manage stomach side effects is standard practice.

Tirzepatide treatment duration is positively correlated with cumulative cardio-metabolic-kidney (CKM) benefits, with patients persisting on therapy for >1 year achieving significantly greater weight loss, lipid improvements, and hepatic/renal marker reductions compared to short-term users.

If you are using tirzepatide for obesity, sticking with it beyond the first year is critical. The data shows that patients who persist for more than a year lose significantly more weight and see greater improvements in heart, liver, and kidney markers than those who stop early. To maximize these benefits, work with your provider to manage side effects and ensure you have the support and resources to stay on the medication long-term.

The protective association between dietary diversity and low muscle mass is significantly stronger in women than in men.

Women may derive greater muscle-protective benefits from dietary diversity than men, possibly due to hormonal differences. Women should prioritize diverse protein and anti-inflammatory food intake to counteract age-related muscle loss.

Athletes with Type 1 Diabetes should maintain pre-exercise blood glucose levels between 7.0–10.0 mmol/L to offset the risk of hypoglycemia, as exercise increases glucose disposal via GLUT4 translocation and insulin sensitivity.

If you have Type 1 Diabetes and are about to exercise, check your blood sugar. If it is below 7.0 mmol/L, do not start exercising yet. Eat carbohydrates or reduce your insulin dose until your blood sugar is between 7.0 and 10.0 mmol/L. This higher starting point acts as a buffer against the blood sugar drop that happens during exercise, keeping you safe and allowing you to perform.

Metabolic and bariatric surgery (MBS) shows a trend toward reducing MACE risk compared to both medical weight management and usual care in patients with obesity and type 2 diabetes, potentially due to metabolic changes independent of weight loss.

Bariatric surgery showed a trend toward reducing heart events compared to usual care or medical weight management in this study. This benefit might come from metabolic changes, not just weight loss. If you are considering surgery, discuss these potential cardiovascular benefits with your healthcare provider, especially if you have type 2 diabetes.

In patients with Type 1 Diabetes (T1D), weight loss interventions reduce insulin requirements but do not significantly improve glycemic control (HbA1c), unlike in Type 2 Diabetes where weight loss directly improves glycemic control.

If you have T1D and are losing weight, do not be discouraged if your HbA1c doesn't drop significantly. The main benefit is that you will likely need less insulin, which reduces your risk of hypoglycemia. Work with your provider to adjust your insulin doses as you lose weight to maintain safety, rather than expecting HbA1c to improve automatically.

Higher levels of the satiety hormone leptin are associated with lower salt taste preference during both low-carbohydrate and low-fat diets.

Your body's satiety hormone, leptin, appears to influence how much you prefer salty foods. Higher leptin levels are linked to a lower preference for salt, regardless of whether you are eating low-carb or low-fat. This suggests a biological link between fullness signals and taste preferences.

GLP-1 receptor agonists (semaglutide, tirzepatide) cause rapid, significant loss of facial and body subcutaneous fat, leading to skin laxity, volume loss, and accelerated facial aging that requires proactive, multimodal aesthetic intervention.

If you are taking Ozempic or Mounjaro, expect your face to lose volume and your skin to sag. Don't wait until you look 'old' to act. Start aesthetic treatments (like fillers or skin tightening) early in your weight loss journey to maintain your shape and youthfulness.

A structured, multimodal aesthetic intervention protocol (fillers, RF, HIFU, collagen stimulators) initiated early in GLP-1 therapy mitigates facial volume loss and skin laxity.

Work with a cosmetologist to create a personalized plan. Use fillers for volume, RF/HIFU for tightening, and collagen stimulators for skin quality. Start early, not after you've lost all the weight.

GLP-1 receptor agonists (e.g., semaglutide) can support sustained weight stability and may be safely restarted postoperatively in body contouring patients.

If you are using GLP-1 agonists like semaglutide for weight loss, discuss with your doctor whether it is safe to restart or continue them after body contouring surgery. They can help maintain your weight stability and support long-term results.

Early intensive intervention targeting stringent glycaemic control (HbA1c ≤ 6.5%) and significant weight loss (≥10%) at diagnosis improves long-term prognosis and prevents microvascular complications in younger patients with longer life expectancy.

If you are diagnosed with Type 2 Diabetes and are under 65, do not accept a standard HbA1c target of 7% as the end goal. Work with your doctor to aim for a stricter target (≤ 6.5%) and significant weight loss (10% or more) immediately. This early, intensive approach is critical for preventing long-term complications like eye and kidney damage, especially given your longer life expectancy.

GLP-1 receptor agonists (GLP-1 RA) and SGLT2 inhibitors are preferred first-line treatments for patients with Type 2 Diabetes and obesity or cardiovascular disease, respectively, due to their weight-reducing and cardioprotective properties.

If you have Type 2 Diabetes and obesity or heart disease, ask your doctor about GLP-1 receptor agonists or SGLT2 inhibitors. These drugs not only help control blood sugar but also promote weight loss and protect your heart, making them preferred choices over metformin alone for many patients.