Browse the evidence

Bariatric surgery (RYGB, sleeve gastrectomy) does not result in clinically significant improvements in semen volume, sperm concentration, morphology, or DNA damage in men with obesity.

Do not expect bariatric surgery to improve your fertility. While it helps with weight, studies show it does not significantly improve sperm quality or DNA integrity. If fertility is a priority, lifestyle changes are a more reliable first step.

An intensive weight loss intervention combining total diet replacements (TDR), behavioral support, and weight loss medications (WLM) as needed achieves and maintains ≥20% weight loss in adults with obesity class I or II, significantly outperforming usual care.

To achieve significant weight loss (≥20%), you need a structured, long-term (2-year) program that combines strict initial calorie restriction (via meal replacements), regular coaching, and physical activity. If you don't lose enough weight in the first month, the program adds medication support. This is more intensive than typical 'eat less, move more' advice, which usually results in minimal weight loss.

Combining resistance training with progressive whey protein supplementation (up to 60g/day) initiated 3 weeks post-surgery counteracts disproportional fat-free mass loss in patients undergoing metabolic bariatric surgery.

If you have had bariatric surgery, standard care may not be enough to protect your muscle. This protocol suggests starting resistance training (both home and supervised) and gradually increasing whey protein intake to 60g per day, starting 3 weeks after surgery. This combination aims to preserve muscle mass, which is crucial for long-term health and metabolic function.

An intensive weight loss intervention combining total diet replacement (800-850 kcal/day), behavioral support, and weight loss medication achieves and maintains >20% weight loss and improves cardiometabolic risk in adults with severe obesity (BMI ≥35 kg/m²) over 2 years.

For severe obesity, standard 'eat less, move more' advice often fails. This protocol uses a 2-year structured approach: start with a very low-calorie formula diet (800-850 kcal) for 12 weeks with weekly support. If you don't lose enough weight, add a GLP-1 medication. Then, gradually transition to a healthy, low-calorie diet while maintaining exercise. The key is the intensive support and the ability to 'rescue' the plan with formula meals or medication if you regain weight.