Browse the evidence

Combining obesity management medications (OMM) with metabolic bariatric surgery (MBS) or endoscopic procedures is an inevitable and necessary component of future personalized obesity care, though optimal protocols are currently undefined.

Future obesity care will likely involve combining medications (like GLP-1s) with surgery or endoscopy. This combination is becoming standard to manage weight regain or suboptimal responses, though specific dosing and timing protocols are still being researched.

Moderate-intensity and high-intensity interval exercise training provide equal cardioprotection against diabetic cardiomyopathy in rats by preventing left ventricular fibrosis and collagen cross-linking.

If you have diabetes or are at risk, both moderate-intensity and high-intensity interval exercise can protect your heart. You do not need to choose high intensity if moderate is more sustainable; both approaches prevent heart damage and fibrosis in this model.

Pyridoxamine supplementation alleviates cardiac fibrosis and oxidative stress in prediabetic rats, preventing left ventricular collagen deposition.

Pyridoxamine may help reduce heart scarring and oxidative stress in prediabetes, but this is based on animal studies. It should not replace lifestyle changes like exercise and diet.

Swearing improves physical performance in short, intense tasks by increasing pain tolerance, state disinhibition, and physiological arousal.

If you are about to perform a short, intense physical task like a heavy lift or a sprint, using a swear word (either aloud or internally) may help you push harder. The effect comes from increased pain tolerance and mental focus. However, be mindful of social contexts where swearing might be inappropriate.

Training to volitional failure, contraction velocity, set configuration, inter-set rest, periodization, time of day, and exercise order do not significantly influence skeletal muscle hypertrophy.

You do not need to obsess over training to failure, specific tempos, exercise order, or rest periods to build muscle. These variables have little to no impact on hypertrophy compared to the main drivers: load, frequency, and volume. Choose what is sustainable for you.

Excessive dietary intake of linoleic acid (LA) leads to the formation of oxidized linoleic acid metabolites (OXLAMs) and alters cardiolipin composition, causing mitochondrial dysfunction and contributing to chronic diseases such as cardiovascular disease, cancer, and Alzheimer's.

Reduce intake of seed oils (soybean, corn, canola, sunflower) to lower linoleic acid consumption. This may help reduce the production of harmful metabolites linked to chronic disease, though the process is slow due to LA's long half-life.

Obesity prevalence has increased significantly in the US since 1980 despite a plateau or decline in national energy intake and stable or increasing physical activity levels since 2000.

Focus on the quality and processing of your food rather than just counting calories. Prioritize minimally processed foods with intact cellular structures (fiber, phytonutrients) and avoid highly processed 'acellular' nutrients. This supports a healthy gut microbiome and metabolic function, which may help regulate body weight more effectively than caloric restriction alone.

Evidence that behavioral weight management programs reduce the incidence of cardiovascular disease or type 2 diabetes is currently sparse and uncertain.

While BWMPs improve risk factors, do not expect them to definitively prevent heart disease or diabetes based on current evidence. The data is too sparse to draw firm conclusions about disease incidence reduction.

HMB supplementation provides minor, inconsistent support for increasing or retaining lean soft-tissue mass (LSTM) in older or clinical populations, but has no evidence of improving physical function.

If you are older or clinically frail, HMB might offer a small benefit for retaining lean mass, especially if you are not exercising. However, do not expect it to improve your strength or physical function. It is not a substitute for exercise or adequate protein intake. If you are healthy and exercising, HMB likely adds no value.

Nutritional interventions, including supplements, do not provide additional benefit to mobility outcomes when combined with physical activity in older adults.

Do not rely on nutritional supplements to improve mobility. Focus on physical activity instead, as supplements have shown no additional benefit when combined with exercise for this population.

Dietary restriction (DR), including caloric restriction (CR) and intermittent fasting (IF), delays aging and extends healthspan by regulating nutrient-sensing pathways and gut microbiota.

To leverage dietary restriction for anti-aging, you don't necessarily need to cut calories drastically all day. Consider Time-Restricted Eating (eating within a 4-12 hour window) or Intermittent Fasting patterns like the 5:2 diet. These methods regulate nutrient-sensing pathways and gut microbiota similarly to strict calorie counting but are easier to sustain long-term. Focus on consistency and moderate restriction (10-30% if doing CR) to avoid negative side effects like muscle loss.

Combining HMB (3g/day) with Resistance Training does not provide a statistically significant additional benefit to muscle mass or strength compared to Resistance Training alone in elderly sarcopenic patients after hip surgery.

You do not need to take HMB if you are doing Resistance Training after hip surgery. RT alone is enough to build muscle and strength; adding HMB does not provide extra benefit for these metrics.

Solo biofragmentable magnetic duodenoileostomy (MagDI) creates a partial intestinal bypass that significantly reduces body weight and improves type 2 diabetes markers in patients with mild obesity (BMI 30-35).

This paper describes a new, minimally invasive surgical option for people with mild obesity (BMI 30-35) and type 2 diabetes. Instead of removing part of the stomach, doctors use magnets to connect the upper small intestine (duodenum) to the lower small intestine (ileum). This creates a partial bypass that helps you lose weight and control blood sugar without major surgery or permanent implants. The magnets dissolve and pass naturally after about 3 weeks. While promising, this is a new procedure with limited long-term data, so it should be considered carefully with a specialist.

Gastric pouch resizing (GPR) for Roux-en-Y gastric bypass (RYGB) failure yields a 53% success rate at 10 years, defined as >50% excess weight loss (%EWL) and/or resolution of comorbidities, despite a 47% failure rate characterized by significant weight regain.

If you have regained weight after a Roux-en-Y gastric bypass, it may be due to your stomach pouch stretching. Gastric pouch resizing is a surgical option that can help restore restriction. However, be aware that nearly half of patients experience significant weight regain within 10 years. This procedure is most effective for those with a specifically dilated pouch and may help resolve other health issues like GERD, but it is not a guaranteed long-term fix for everyone.

Cultural evolution, specifically the adoption of cooking and processed foods, provided the necessary energy surplus to drive human brain expansion and physiological reconditioning, establishing an evolutionary trajectory that predisposes modern humans to obesity in obesogenic environments.

Understand that your body's drive to store fat is an evolutionary adaptation to a high-energy niche created by cooking and tool use, not a moral failing. In a modern environment with unlimited processed food, this adaptation becomes maladaptive. The solution requires changing the environment (non-obesogenic) rather than just relying on willpower.

Commercial protein supplements frequently make unauthorized health claims (e.g., 'post-workout recovery', 'muscle growth') that are not supported by EFSA regulations, whereas only specific claims regarding muscle mass increase/maintenance and bone maintenance are legally authorized.

When buying protein supplements in Europe, ignore marketing buzzwords like 'fast recovery' or 'instant growth' on the label. Legally, these are unauthorized. Look for the specific, EFSA-approved phrase: 'Protein contributes to muscle mass increase' or 'maintenance of muscle mass'. If a product claims 'recovery' without this specific phrasing, it is non-compliant with EU regulations.

Roux-en-Y gastric bypass (RYGB) surgery is the only treatment for morbid obesity that conveys substantial and sustained weight loss and long-term remission of obesity-related comorbidities, whereas lifestyle interventions have failed to reduce cardiovascular event rates in obese patients with type 2 diabetes.

For individuals with morbid obesity (BMI >40 or >35 with comorbidities), lifestyle interventions alone are insufficient for sustained weight loss and cardiovascular risk reduction. Bariatric surgery, specifically Roux-en-Y gastric bypass, is identified as the only treatment providing substantial, sustained weight loss and remission of comorbidities.

Resistance training frequency (2x vs 4x per week) does not significantly alter patellar tendon morphological adaptations (Cross-Sectional Area or Length) when volume is equated.

Do not expect your tendons to get thicker (hypertrophy) from 8-12 weeks of resistance training, regardless of whether you train 2 or 4 times a week. Focus on strength gains, which can occur without visible morphological changes in this timeframe.

Body size metrics (BMI, waist circumference) factor load independently of cardiometabolic health metrics (lipids, blood pressure), suggesting they are distinct latent constructs rather than a single unified 'obesity' phenotype.

Your health is not defined solely by your weight. This study shows that body size and metabolic health (like blood pressure and cholesterol) are distinct factors. You can improve your metabolic health through weight-neutral approaches (like focusing on nutrition and activity without emphasizing weight loss) without needing to lose weight first. This reduces stigma and may improve engagement with health behaviors.

Sulfur amino acid restriction (SAAR) induces transcriptional remodeling in white adipose tissue (WAT), upregulating ribosomal processes and downregulating structural components, without significantly altering classical metabolic risk biomarkers like lipids or glucose.

While you won't see immediate changes in your cholesterol or blood sugar, your fat tissue is biologically changing at the genetic level. Specifically, your cells are adjusting their protein synthesis machinery (ribosomes) and structural components, which may support long-term metabolic health.

Small molecule-based therapies and reprogramming strategies can ameliorate or reverse aging-related conditions by manipulating epigenetic mechanisms.

Epigenetic rejuvenation therapies are being developed. Consult a healthcare provider for emerging treatments.

Targeting mitochondrial dysfunction through dietary supplements (e.g., NAD+ precursors, antioxidants) and pharmacological agents shows promise in preclinical models but lacks robust clinical translation due to issues with stability and efficacy.

While specific mitochondrial supplements and drugs are being researched, current clinical evidence is limited. The most accessible way to support mitochondrial health remains regular physical activity, which promotes mitochondrial biogenesis and function, alongside a balanced diet that provides necessary nutrients for mitochondrial function.

Mitochondrial transplantation, involving the transfer of healthy mitochondria to damaged cells, is a promising preclinical therapy for various diseases but faces challenges in clinical translation due to unstable vitality and transient effects.

Mitochondrial transplantation is an experimental therapy currently limited to research settings and specific clinical trials. It is not a standard treatment. Patients interested in this therapy should consult with their healthcare provider about available clinical trials.

Wearable activity trackers have small or non-significant effects on physiological markers (blood pressure, cholesterol, glycosylated haemoglobin) and psychosocial outcomes (quality of life, pain).

While using a wearable activity tracker will likely increase your physical activity and help with weight loss, do not expect it to significantly lower your blood pressure, cholesterol, or blood sugar on its own. Similarly, improvements in quality of life or pain reduction are not guaranteed. The primary benefit is increased movement.