Browse the evidence

Higher protein intake (≥25% TDE or ≥1.25 g/kg/day) during energy restriction promotes greater fat loss and fat-free mass preservation compared to standard protein intakes, with modest but clinically relevant long-term weight maintenance benefits.

To maximize fat loss and preserve muscle while dieting, aim for at least 1.25 grams of protein per kilogram of body weight daily, or roughly 25% of your total calories from protein. This approach helps you feel fuller longer and burns slightly more calories through digestion, leading to better fat loss and muscle retention than standard protein intakes.

Daily exercise training (morning or evening) reduces fasting concentrations of large LDL particles (LDL-1) and small HDL particles (HDL-3/4) in men with overweight/obesity, independent of time-of-day.

If you are overweight or obese, engaging in daily exercise (combining high-intensity intervals and moderate cycling) for just 5 days can significantly improve your LDL and HDL particle profiles, regardless of whether you exercise in the morning or evening. Focus on consistency and intensity rather than the specific time of day.

Triple agonist Retatrutide (12 mg/week for 48 weeks) and dual agonist Tirzepatide (15 mg/week for 72 weeks) produce superior weight loss (24.2% and 20.9% respectively) in adults with obesity compared to traditional anti-obesity medications, with even greater effects in those with BMI ≥ 35 kg/m².

Newer drugs like Retratrutide (triple agonist) and Tirzepatide (dual agonist) offer significantly higher weight loss (20-26%) than older drugs. Retratrutide 12mg weekly for 48 weeks and Tirzepatide 15mg weekly for 72 weeks are key examples. These are more effective than traditional options, especially for those with BMI ≥ 35, but cost is a major barrier.

GLP-1 receptor agonists (GLP-1RAs) and sodium-glucose co-transporter-2 inhibitors (SGLT2-is) significantly improve hepatic steatosis and steatohepatitis in patients with MASLD, primarily through weight loss and glycemic control, with some agents also demonstrating antifibrotic properties.

If you have fatty liver disease (MASLD), especially if you also have type 2 diabetes or obesity, GLP-1 receptor agonists (like semaglutide or liraglutide) and SGLT2 inhibitors (like empagliflozin or dapagliflozin) are currently the most effective and accessible pharmaceutical options. They work by improving insulin sensitivity, promoting weight loss, and directly reducing liver fat and inflammation. While they may require injections (for GLP-1RAs) and can cause mild stomach upset, their benefits for both liver and heart health make them a cornerstone of treatment. Always consult your doctor to determine the best option for your specific health profile.

Resistance exercise is the most effective lifestyle intervention for increasing muscle strength in people with type 2 diabetes (T2D), although it may induce an anabolic resistance regarding muscle mass gains compared to healthy controls.

For people with Type 2 Diabetes, resistance training is the best way to build strength. While it might not build as much muscle mass as it does in healthy people (due to 'anabolic resistance'), it is still superior to aerobic exercise for strength. Aim for at least two days a week of resistance training, potentially starting with home-based programs if gym access is a barrier.

Pharmacotherapies for T2D and obesity, specifically GLP-1 receptor agonists (e.g., Tirzepatide) and SGLT2 inhibitors, cause significant loss of lean body mass (20-50% of total weight loss), necessitating concurrent resistance exercise and protein intake to mitigate muscle loss.

If you are taking GLP-1 or SGLT2 medications for diabetes or weight loss, expect to lose some muscle along with fat (up to 50% of the weight). To protect your metabolism and strength, you must combine these medications with resistance exercise and adequate protein intake, as the drugs themselves do not preserve muscle.

Unimolecular GLP1R/GIPR dual agonists (e.g., tirzepatide) produce superior body weight reduction and glycemic improvements compared to GLP-1 receptor agonists alone, driven by GIP receptor signaling in central nervous system GABAergic neurons.

If you are managing obesity or Type 2 Diabetes, dual-acting medications (like tirzepatide) that target both GLP-1 and GIP receptors have shown superior weight loss (up to 20-22%) compared to GLP-1 only drugs. These are taken once weekly. Discuss with your doctor if this option is suitable, noting it may help mitigate some nausea associated with GLP-1 only treatments.

Tirzepatide (5, 10, and 15 mg) achieves stringent glycemic (HbA1c < 5.7% or ≤ 6.5%) and weight loss (≥ 10% or ≥ 15%) targets with a statistically significantly lower cost per responder and lower number needed to treat (NNT) compared to semaglutide 1 mg in patients with type 2 diabetes.

If you have Type 2 Diabetes and are struggling to reach strict blood sugar (HbA1c < 5.7% or ≤ 6.5%) or significant weight loss goals (≥ 10-15%) with metformin, switching to or starting tirzepatide (5-15 mg weekly) is likely more effective and cost-efficient for achieving those specific targets than using semaglutide 1 mg. While tirzepatide has a higher yearly drug price, you are more likely to succeed with it, making it 'cheaper' per successful outcome.

Semaglutide demonstrates superior weight loss and glycemic control compared to other GLP-1RAs like liraglutide and dulaglutide, with weight loss ranging from 10% to over 20%.

Semaglutide (Wegovy) is a once-weekly injection that has shown significant weight loss (10-20%) in clinical trials, outperforming other drugs in its class. It is approved for chronic weight management in adults and adolescents. You must combine it with diet and exercise. Be aware that it is expensive and may face supply shortages due to high demand.

Tirzepatide, a dual GIP and GLP-1 receptor agonist, provides superior weight loss and metabolic improvements compared to selective GLP-1RAs, insulin, and placebo.

Tirzepatide is a once-weekly injection that targets two hormones (GIP and GLP-1) to improve blood sugar and promote weight loss. Clinical trials show weight loss of 15-21% depending on the dose. It is approved for Type 2 Diabetes and is being studied for obesity. It is more effective than some other GLP-1 drugs and insulin in terms of weight loss and metabolic markers.

Tirzepatide, a dual GIP and GLP-1 receptor agonist, provides superior glycemic control and weight reduction compared to semaglutide and insulin in patients with type 2 diabetes.

For patients with type 2 diabetes, especially those with cardiovascular risks or obesity, tirzepatide offers a powerful once-weekly treatment option. It significantly lowers blood sugar and promotes substantial weight loss, often outperforming other common medications like semaglutide or insulin. While cost and injection concerns exist, the clinical benefits for glycemic control and weight management are substantial.

Treatment with semaglutide 2.4 mg for 12 months significantly reduces body weight and improves cardiometabolic risk factors (blood pressure, lipids, HbA1c) in adults with obesity or overweight compared to no obesity medication treatment.

If you have obesity or overweight with related health issues, semaglutide 2.4 mg taken once weekly for a year can lead to significant weight loss (around 15%) and improvements in blood pressure, cholesterol, and blood sugar compared to not using obesity medication. It requires a gradual dose increase to 2.4 mg and should be combined with diet and exercise.

Weekly subcutaneous semaglutide (2.4 mg) combined with lifestyle interventions produces clinically significant weight loss (mean -14.9%) in adults with obesity, outperforming daily liraglutide (3.0 mg) in magnitude and duration of effect.

If you have obesity, weekly semaglutide injections (2.4 mg) combined with diet and exercise can help you lose nearly 15% of your body weight. This is significantly more effective than daily liraglutide. Start with a low dose to minimize nausea, and stick with it, as the benefits persist longer than other treatments.

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) including liraglutide, exenatide, semaglutide, and dulaglutide produce statistically significant weight loss in obese individuals, with intervention groups losing 5.1 to 6.16 kg compared to 1.6 to 3.97 kg in control groups.

If you are obese, GLP-1 receptor agonists like liraglutide or semaglutide are proven to help you lose weight significantly more than lifestyle changes alone. These medications work by mimicking a hormone that makes you feel full and slows down digestion. While they are injections, they have been shown to be safe and effective for adults aged 18-65, helping to reduce body fat and improve metabolic health.

Tirzepatide 15 mg administered once weekly for 72 weeks is the most cost-efficient intervention for achieving high-magnitude weight loss targets (15% and 20%) in adults with obesity, yielding a cost per kilogram of weight loss of £89.24.

For adults with obesity seeking significant weight loss, the 15mg weekly dose of tirzepatide, combined with diet and exercise, offers the best value for achieving major weight reduction goals (15-20%) over 72 weeks, despite higher initial drug costs, due to superior efficacy and potential long-term healthcare savings.

Tirzepatide 10 mg is the most cost-efficient dose for achieving moderate weight loss targets (10% and 15%) and provides competitive outcomes for BMI improvement compared to 5mg and 15mg doses.

For patients targeting moderate weight loss (10-15%), the 10mg weekly dose of tirzepatide offers a strong balance of efficacy and cost-efficiency, often outperforming lower doses and competing well with higher doses for BMI improvements.

GLP-1 receptor agonists (GLP1-RA), particularly long-acting formulations, provide superior glycaemic control, weight loss, and cardiovascular risk reduction compared to short-acting GLP1-RA, and are recommended for chronic weight management and MACE reduction.

Long-acting GLP-1 receptor agonists (like semaglutide or liraglutide) are highly effective for T2DM and weight loss. They offer better glycaemic control and fewer hypoglycemic episodes than short-acting versions. If you dislike injections, oral semaglutide is an effective alternative.

Composite meals with high fiber, low total fat, and minimal processing elicit significantly lower postprandial metabolic stress (GlucoTRIG index) compared to meals high in fat and refined foods, despite similar caloric content.

To minimize metabolic stress after a meal, prioritize high-fiber, low-fat whole foods (like beans, vegetables, and fruits) over processed foods high in fat, even if the high-fat meal has fewer carbohydrates. A meal with 58% carbohydrates but high fiber and low fat (like the study's Meal 3) was metabolically healthier than meals with lower carbohydrates but higher fat content.

Newer anti-obesity medications (GLP-1 and GLP-1/GIP agonists like semaglutide and tirzepatide) produce significantly greater weight loss (15-22.5%) compared to lifestyle modifications alone, which typically yield modest and unsustainable results.

Newer GLP-1 and GLP-1/GIP medications (like semaglutide and tirzepatide) are significantly more effective for weight loss (15-22.5%) than lifestyle changes alone. However, access is difficult due to insurance coverage, supply shortages, and cost. These medications should be viewed as a tool to help manage obesity as a chronic disease, but they still require lifestyle support and are not a 'magic pill' without side effects or administrative burdens.

GLP-1 receptor agonists (semaglutide and tirzepatide) are effective treatments for weight regain after bariatric surgery, producing clinically significant weight loss without severe adverse events.

If you regain weight after sleeve gastrectomy, GLP-1 medications like semaglutide or tirzepatide are effective and safe options to help you lose it back, avoiding the need for high-risk revisional surgery.

Tirzepatide (15 mg once weekly) combined with lifestyle counseling produces a mean weight loss of 20.9% over 72 weeks in patients with obesity or overweight.

If you are prescribed Tirzepatide (Zepbound), expect to take a 15 mg injection once weekly. This works best when combined with a 500 kcal daily caloric deficit, physical activity, and lifestyle counseling. Be prepared for potential gastrointestinal side effects like nausea, which can often be managed by eating smaller meals.

Semaglutide (2.4 mg once weekly) produces a mean weight loss of 14.9% over 68 weeks in patients with obesity without diabetes.

If you are prescribed Semaglutide (Wegovy), expect to take a 2.4 mg injection once weekly. This can lead to a 14.9% reduction in body weight over 68 weeks. Be prepared for potential gastrointestinal side effects like nausea, which can often be managed by eating smaller meals.

Liraglutide (3 mg once daily) produces a mean weight loss of 8% over 56 weeks in patients without diabetes.

If you are prescribed Liraglutide (Saxenda), expect to take a 3 mg injection once daily. This can lead to an 8% reduction in body weight over 56 weeks. Be prepared for potential gastrointestinal side effects like nausea, which can often be managed by eating smaller meals.

Subcutaneous semaglutide (up to 1.0 mg once-weekly) produces significantly greater reductions in BMI and waist circumference compared to liraglutide (up to 3.0 mg once-daily) in obese patients with type 2 diabetes over a 12-month period, while both agents significantly lower HbA1c.

For obese patients with type 2 diabetes, switching from or choosing semaglutide over liraglutide is likely to result in greater weight loss and waist circumference reduction. While both drugs effectively lower blood sugar, semaglutide offers superior body composition benefits. Patients should be aware that gastrointestinal side effects are common, especially with semaglutide, but these often subside as the dose is titrated up.