Browse the evidence

GLP-1 receptor agonists and SGLT2 inhibitors are preferred glucose-lowering medications for obese diabetic patients because they promote weight loss (5.3 kg and 2.4 kg respectively), whereas sulfonylureas, TZDs, and insulin promote weight gain.

If you are taking diabetes medication and struggling with weight, ask your doctor about switching to GLP-1 agonists (like semaglutide or liraglutide) or SGLT2 inhibitors (like empagliflozin), which help you lose weight. Avoid medications like insulin, sulfonylureas, or TZDs if possible, as they tend to cause weight gain.

Semaglutide 2.4 mg is a cost-effective treatment for obesity and overweight in the US, providing greater weight loss and QALYs than diet/exercise, no treatment, or other anti-obesity medications, provided the willingness-to-pay threshold is $150,000 per QALY.

For patients with obesity or overweight plus comorbidities, semaglutide 2.4 mg combined with diet and exercise is a cost-effective medical option in the US, offering significant weight loss and quality-adjusted life years compared to lifestyle changes alone or other medications, assuming a willingness-to-pay threshold of $150,000 per QALY.

Anti-obesity medications (AOMs) are effective adjuncts for weight reduction and treating adiposopathy, but their efficacy is contingent upon adherence and individual metabolic response, with weight regain occurring if treatment is discontinued.

Use FDA-approved anti-obesity medications as a long-term tool to manage obesity, not just for short-term weight loss. They work best when combined with nutrition and exercise. Do not stop the medication just because you hit a target weight; stopping often leads to regain. Discuss specific drugs (like Semaglutide or Phentermine) with your doctor based on your health profile.

High protein diets increase satiety and preserve fat-free mass during weight loss through increased anorexigenic hormones (GLP-1, PYY, CCK), decreased orexigenic hormones (ghrelin), and higher diet-induced thermogenesis, though long-term satiety benefits may diminish due to adaptation.

Prioritize protein intake (approx. 27-35% of calories) to help manage hunger and preserve muscle mass. This works by boosting satiety hormones and increasing the energy cost of digestion, though be aware that your body may adapt to this over very long periods.

Whey protein supplementation significantly reduces interleukin-6 (IL-6) and increases insulin-like growth factor-1 (IGF-1) and albumin levels in older adults with sarcopenia.

Whey protein supplementation not only helps with muscle mass but also improves key biochemical markers in older adults with sarcopenia. It significantly reduces inflammation (IL-6) and increases beneficial hormones (IGF-1) and proteins (albumin). This suggests broader health benefits beyond just muscle size.

Liraglutide 3.0 mg/day significantly reduces body weight in adults with obesity or overweight (BMI ≥30 or ≥27 with comorbidities) compared to placebo, with effects sustained over 56 weeks.

If you have obesity or are overweight with related health issues like high blood pressure, a daily 3.0 mg injection of liraglutide, combined with a modest calorie deficit and exercise, can help you lose significantly more weight than lifestyle changes alone. Start with a lower dose to let your body adjust to potential stomach side effects, then increase to the full dose over several weeks.

Liraglutide 1.8 mg/day improves glycemic control (HbA1c reduction) in patients with Type 2 Diabetes compared to placebo, rosiglitazone, glimepiride, insulin glargine, and exenatide.

For Type 2 Diabetes, a daily 1.8 mg injection of liraglutide effectively lowers blood sugar, often better than insulin or other common diabetes medications, while avoiding the weight gain often caused by insulin. It is typically added to existing medications like metformin.

GLP-1 receptor agonists (liraglutide, semaglutide, dulaglutide) produce significant weight loss in obese patients (BMI ≥30 or ≥27 with comorbidities) through mechanisms including delayed gastric emptying, increased satiety, and increased resting energy expenditure.

If you have obesity or overweight with related health issues, GLP-1 medications like liraglutide are a proven, effective treatment. They work by mimicking a hormone that signals fullness and increases energy use, not just by slowing digestion. You take a daily injection, but the significant weight loss and health improvements can be worth it. Always consult a doctor to see if you are a candidate, especially if you have a history of thyroid cancer.

The combination of phentermine and topiramate is highly effective for weight reduction, particularly in patients with compulsive overeating or bulimia nervosa, by reducing food intake through central mechanisms.

Phentermine/topiramate is a powerful combination for weight loss, especially for those with binge eating issues. It reduces food intake centrally. It is effective but has significant side effects and contraindications (e.g., glaucoma, hyperthyroidism). It is not approved in Europe due to safety concerns. Use only under strict medical supervision.

GLP-1 receptor agonists (specifically liraglutide and semaglutide) induce clinically significant, sustained body weight reduction in individuals with overweight or obesity, with histological resolution of NASH observed in approximately 40% to 60% of patients.

If you have obesity or type 2 diabetes, GLP-1 medications like semaglutide or liraglutide are highly effective for losing weight and improving liver health (NASH). They work by mimicking a gut hormone that reduces appetite and improves blood sugar control. While they require injections (or a daily pill for semaglutide) and may cause temporary stomach issues, the weight loss benefits are substantial and sustained when combined with lifestyle changes.

Incretin-based pharmacotherapies (GLP-1 and GIP/GLP-1 agonists) induce substantial weight loss (up to 20%) in obesity, which significantly reduces OSA severity and improves cardio-metabolic health outcomes more effectively than continuous positive airway pressure (CPAP) therapy.

If you have obesity-related sleep apnea, talk to your doctor about incretin-based medications (like semaglutide or tirzepatide). These drugs help you lose significant weight (often 15-20%) by regulating hormones that control hunger and digestion. This weight loss can reduce your sleep apnea severity and improve your heart health more effectively than CPAP alone. Be prepared for potential gastrointestinal side effects and understand that these medications are likely intended for long-term use to maintain results.

Novel glucose-lowering agents, specifically GLP-1 receptor agonists (semaglutide) and dual GIP/GLP-1 agonists (tirzepatide), induce significant weight loss and glycemic improvement, with tirzepatide showing remission rates of 66-81% in clinical trials.

Newer injectable medications like Tirzepatide and Semaglutide are highly effective for diabetes remission, with remission rates up to 81% for Tirzepatide. They work by mimicking gut hormones to improve insulin function and promote weight loss. Discuss these options with your doctor if lifestyle changes alone are insufficient.

Glucagon-like peptide-1 receptor agonists (GLP-1RA) such as liraglutide and semaglutide induce significantly greater weight loss and reduce hepatic fat content compared to lifestyle modification and first-generation anti-obesity drugs.

If you have obesity, Type 2 Diabetes, or fatty liver disease (MASLD), GLP-1 receptor agonists like semaglutide or liraglutide are currently the most effective pharmacological treatments for weight loss, outperforming lifestyle changes alone and older weight-loss drugs. They work by targeting brain centers to reduce appetite and also directly reduce liver fat. While they can cause side effects like nausea, their ability to improve metabolic health and liver disease makes them a superior option for many patients, though adherence to the regimen is critical.

Tirzepatide (TZP) administration in adults with overweight or obesity significantly reduces total fat mass and visceral adipose tissue compared to baseline, placebo, and other anti-obesity medications like dulaglutide and semaglutide.

Tirzepatide is a highly effective treatment for reducing body fat and visceral fat in people with overweight or obesity, outperforming other common medications like semaglutide and dulaglutide in fat reduction metrics. However, users should be aware that significant fat-free mass (muscle) loss also occurs, though the net benefit of fat reduction remains superior. Treatment involves weekly injections, typically titrated up to 15mg over several months.

Orforglipron, an oral non-peptide GLP-1 receptor agonist, demonstrates efficacy comparable to injectable GLP-1 RAs with fewer dosing restrictions, achieving up to 2.10% HbA1c reduction and 9.6% weight loss.

Orforglipron is an oral, non-peptide GLP-1 receptor agonist that offers a convenient once-daily dosing without the strict food and water restrictions of other oral GLP-1 RAs. In Phase 2 trials, it achieved significant HbA1c reduction (up to 2.10%) and weight loss (9.6%), comparable to injectable options. It is currently in Phase 3 trials.

Adherence to a Mediterranean diet improves hepatic steatosis and insulin resistance in NAFLD patients, even in the absence of significant weight loss.

Adopt a Mediterranean-style eating pattern focusing on low-glycemic carbohydrates, healthy fats (olive oil, nuts), and high fiber. This approach improves liver fat and insulin sensitivity independently of weight loss, making it a viable strategy even if you struggle to lose weight through caloric restriction alone.

Subcutaneous semaglutide (1.0 mg weekly) produces significantly greater weight loss and improvements in metabolic markers (BMI, waist circumference, HbA1c, fasting glucose, systolic BP) compared to other GLP-1 receptor agonists (liraglutide, exenatide, dulaglutide) in patients with type 2 diabetes.

For patients with Type 2 Diabetes seeking weight loss, subcutaneous semaglutide (1.0 mg weekly) is a more effective option than other common GLP-1 agonists like liraglutide or dulaglutide. It leads to greater reductions in body weight, BMI, and waist circumference, as well as better improvements in blood sugar (HbA1c) and blood pressure. While gastrointestinal side effects like nausea are common, they often decrease over time, and the metabolic benefits are substantial.

Tirzepatide (a dual GLP-1/GIP agonist) is more effective than semaglutide (1.0 mg weekly) for inducing weight loss and improving metabolic markers in patients with type 2 diabetes.

If semaglutide does not provide sufficient weight loss or metabolic control, switching to tirzepatide (5-15 mg weekly) may offer significantly greater benefits. Tirzepatide, which targets both GLP-1 and GIP receptors, has been shown to produce larger weight reductions and better improvements in blood sugar and blood pressure compared to semaglutide in patients with Type 2 Diabetes.

GLP-1 receptor agonists (semaglutide, liraglutide, tirzepatide) produce clinically significant weight loss (8-24%) in obese patients, serving as an effective alternative to bariatric surgery for preoperative optimization in joint arthroplasty candidates.

GLP-1 agonists like Semaglutide (Wegovy/Ozempic) and Tirzepatide (Zepbound/Mounjaro) are highly effective for weight loss, achieving 15-20% body weight reduction in clinical trials. For patients with osteoarthritis, this weight loss can significantly reduce joint pain and improve surgical outcomes. If you are considering joint replacement, discuss these medications with your doctor as a potential bridge to surgery. Be aware that gastrointestinal side effects like nausea are common initially but often subside as your body adjusts to the medication. Oral versions are also available if you prefer to avoid injections.

Achieving a weight loss of 15% or more can reverse type 2 diabetes metabolic abnormalities and induce remission, an outcome not achievable with current glucose-lowering pharmacotherapies alone.

To potentially reverse type 2 diabetes, you need to lose a significant amount of weight—specifically 15% or more of your body weight (often around 10kg or more for many patients). This level of loss, achieved through intensive lifestyle changes like low-calorie diets, can reverse metabolic abnormalities in about half of patients within a year. Standard diabetes medications alone typically cannot achieve this reversal. The key challenge is maintaining this loss because your body will biologically fight back (metabolic adaptation), so long-term success requires sustained behavioral support and physical activity.

Once-weekly subcutaneous semaglutide 2.4 mg significantly improves weight-related quality of life (IWQOL-Lite-CT) and health-related quality of life (SF-36v2) compared to placebo in adults with overweight or obesity, independent of the magnitude of weight loss in some domains.

If you have obesity or overweight with related health issues, once-weekly semaglutide 2.4 mg, combined with lifestyle changes, significantly improves your quality of life, including physical function, mental health, and control over food cravings, compared to placebo. This benefit is sustained over time and is driven by fat loss rather than muscle loss.

Semaglutide 2.4 mg significantly improves control of eating, including craving control and craving for savory, sustained up to week 104, compared to placebo.

Semaglutide 2.4 mg helps you control your eating, including cravings for savory and sweet foods, with benefits sustained up to 104 weeks. This is achieved through once-weekly injections combined with lifestyle changes.

Expanded access to GLP-1 and GIP/GLP-1 receptor agonists (e.g., semaglutide, tirzepatide) for eligible populations could avert approximately 42,000 deaths annually in the US by reducing obesity-related mortality.

If you are eligible for GLP-1/GIP agonists based on BMI and comorbidities, expanding insurance coverage and manufacturing capacity could save tens of thousands of lives annually by reducing obesity-related mortality. Current barriers like cost and supply shortages prevent many from accessing these life-saving treatments.

Fortifying plant-based protein blends with leucine to match the leucine content of whey protein stimulates muscle protein synthesis (MPS) to an equivalent extent as whey protein in young healthy adults.

If you are using plant-based protein, ensure it is fortified with leucine or is a blend designed to match the leucine content of whey protein. A 20g dose of such a fortified plant protein will stimulate muscle protein synthesis just as effectively as 20g of whey protein in young, healthy adults.