Browse the evidence

Obesity pharmacotherapy is recommended against for compounded medications or unapproved medications due to safety and efficacy concerns.

Avoid compounded weight loss medications. They are not approved, may be unsafe, and are not proven to work. Stick to FDA/Health Canada-approved medications prescribed by your doctor.

Current randomized controlled trials of nutrient-stimulated hormone-based therapies (NuSHs) for obesity predominantly fail to assess nutritional and functional outcomes, focusing almost exclusively on body weight.

If you are participating in or designing a NuSH trial, you must include nutritional and functional assessments (body composition, muscle strength, bone health) alongside weight. Relying solely on weight masks potential risks like sarcopenia and bone loss.

Males in the US have consistently higher diabetes incidence and prevalence than females across all age groups, with a significant disparity that becomes more pronounced in older cohorts.

Men in the US are diagnosed with diabetes more often than women, and this gap widens with age. This may be partly due to biological factors and partly due to less frequent healthcare engagement. Men should prioritize regular screening and not delay care due to cultural norms.

Lower drug prices for semaglutide and tirzepatide could significantly improve their cost-effectiveness, potentially making them competitive with surgical and behavioral interventions.

If drug prices for semaglutide and tirzepatide were reduced, these medications could become cost-effective options for managing class III obesity, potentially offering a non-surgical alternative.

The lack of a unified definition for resistance exercise (RE) in scientific literature leads to heterogeneous inclusion criteria in systematic reviews, which obscures the true magnitude of effects and impairs the development of evidence-based guidelines.

When evaluating resistance training advice or research, check if the definition of 'resistance' is explicit. If a study or program mixes bodyweight exercises, plyometrics, and weighted lifting without distinguishing them, the results may be less precise. For optimal strength or hypertrophy, ensure the training modality matches your specific goal (e.g., traditional strength vs. plyometrics) rather than assuming all 'resistance' is equal.

Performing 1 or 2 sets of 3-4 repetitions at 55-75% of 10RM as a specific warm-up provides no performance benefit over no warm-up for resistance-trained individuals performing multiple sets to failure at ~10RM loads.

If you are training with moderate weights (around 10 reps max) and doing multiple sets to failure, you likely do not need a specific warm-up. Skipping it saves 2-5 minutes per exercise without hurting your performance. However, if you are lifting very heavy (1-3RM) or are concerned about injury, you may still want to warm up. Listen to your body, but don't feel obligated to warm up if it's just for performance gains at moderate loads.

Approximately 10% of the U.S. population consumes more than 5000 mg of sodium per day, which is more than twice the recommended limit of 2300 mg/day, with extreme intake levels showing no meaningful decline between 2003 and 2018.

Check your sodium intake if you are in the top 10% of consumers. If you are eating more than 5000mg daily, you are consuming more than double the recommended limit. This level of intake is associated with higher cardiovascular risk and is not declining in the population, suggesting a need for targeted reduction strategies.

Sodium intake among boys in the U.S. shows an alarming accelerating increase over time, whereas girls show a steady decline, indicating a diverging gender trend in extreme sodium consumption.

Parents of boys should be particularly vigilant about sodium intake, as trends show it is accelerating in this group. Focus on reducing processed foods and restaurant meals, which are the main sources of sodium.

Current sodium reduction efforts in the U.S. are insufficient to meet the WHO's global target of a 30% sodium reduction by 2030, as extreme intake levels remain high and show no meaningful decline.

Current public health strategies are not working to reduce extreme sodium intake. More aggressive interventions are needed to meet global health targets.

Standard diagnostic thresholds for natriuretic peptides (BNP/NT-proBNP) are less sensitive in individuals with obesity, potentially missing cases of HFpEF, necessitating adjusted cutoffs or alternative screening scores.

If you have obesity, standard blood tests for heart failure (BNP/NT-proBNP) might not be sensitive enough to detect early problems. Ensure your doctor interprets these results in the context of your weight or uses specialized scoring systems (like the HFpEF-ABA score) that account for obesity.

Over an 8-year period, middle-aged adults of African origin across diverse geographic and socioeconomic settings experienced significant increases in the prevalence and incidence of obesity, high blood glucose, and high blood pressure, with the steepest increases occurring in low- and middle-income countries (Ghana, Jamaica, Seychelles) compared to the USA.

If you are of African descent, your risk for obesity, high blood sugar, and high blood pressure is actively increasing as you age, regardless of whether you live in a wealthy or developing country. The rate of increase is often faster in lower-income settings. This is not inevitable fate but a result of environmental and lifestyle shifts; proactive monitoring and lifestyle interventions are critical to mitigate this rising risk.

Intensive lifestyle interventions (ILI) targeting weight loss and physical activity in older adults (≥70 years) with type 2 diabetes and obesity are associated with increased odds of severe mobility disability compared to diabetes support and education (DSE).

For adults over 70 with type 2 diabetes, aggressive weight loss programs may increase the risk of severe mobility disability compared to standard diabetes education. Focus should shift towards preserving functional status and muscle mass rather than prioritizing significant weight reduction, as the loss of lean mass can outweigh the benefits of fat loss for mobility in this age group.

Pre-training bone characteristics (bone mineral content, bone area, shoulder/hip widths) do not meaningfully predict the magnitude of appendicular lean tissue mass hypertrophy following 10-12 weeks of resistance training in untrained adults.

Do not let your bone structure (shoulder width, hip width, or bone density) dictate your expectations for muscle growth. While larger bones are associated with more muscle at rest, they do not predict how much muscle you will gain from training. Focus on progressive overload and consistency; your skeletal frame is not a limiting factor for hypertrophy potential.

Pre-exhaustion resistance training (single-joint immediately before multi-joint) does not produce superior muscle hypertrophy or strength gains compared to traditional resistance training and may result in slightly lower hypertrophy due to reduced volume load.

If your goal is maximum muscle growth, stick to traditional resistance training (performing all sets of one exercise before moving to the next). While pre-exhaustion (doing a single-joint exercise right before a compound one) is time-efficient and viable for strength and endurance, it likely results in slightly less muscle growth because you lift less total weight (volume load) on the compound movements due to fatigue. Do not sacrifice volume load on compound lifts for the sake of pre-fatiguing muscles if hypertrophy is your primary goal.

Pre-training bone characteristics (bone mineral content, bone area, shoulder/hip width) do not significantly predict the magnitude of appendicular lean tissue mass gains following 10–12 weeks of resistance training in untrained adults.

Do not worry about your bone structure or frame size when starting resistance training. Whether you have wide shoulders or narrow hips, your potential for muscle growth is not determined by your skeleton. Focus on consistent training with progressive overload (increasing weight/reps over time) and adequate protein intake, as these are the drivers of hypertrophy, not your baseline bone density or width.

The adverse association between elevated BMI (>27 kg/m²) and mortality in HFrEF patients is significantly stronger in those with ischemic cardiomyopathy compared to non-ischemic cardiomyopathy.

If your heart failure is caused by coronary artery disease (ischemic), keeping your BMI under 27 is particularly important for your survival. In patients with non-ischemic heart failure, the link between higher BMI and death was not statistically significant in this study, suggesting that weight management strategies might need to be tailored to your specific heart condition.

Bariatric surgery (RYGB, Sleeve Gastrectomy) provides superior and more sustained weight loss (25-35%) and metabolic remission compared to pharmacotherapy, but carries higher surgical risks and potential for long-term complications.

Bariatric surgery (like gastric bypass or sleeve gastrectomy) is the most effective treatment for severe obesity, typically resulting in 25-35% weight loss. It offers significant improvements in diabetes and hypertension. However, it is invasive, carries surgical risks, and requires lifelong nutritional monitoring. It is generally recommended for those with BMI ≥ 40 or ≥ 35 with comorbidities who have not succeeded with other methods.

Bariatric surgery (specifically Roux-en-Y Gastric Bypass and Sleeve Gastrectomy) is the most effective intervention for sustained weight loss and metabolic improvement, significantly altering gut microbiota diversity and reducing systemic inflammation.

Bariatric surgery, such as Roux-en-Y Gastric Bypass or Sleeve Gastrectomy, offers the most significant and durable weight loss for severe obesity. It works by restricting stomach size and altering gut hormones and microbiota. Patients must commit to lifelong vitamin supplementation to prevent deficiencies.

Hamstring hypertrophy plays a minimal role in strength transfer between the Nordic hamstring exercise (NHE) and the stiff-leg deadlift (SDL) in resistance-untrained individuals.

If you want to improve strength in both Nordic Hamstring Exercises and Stiff-Leg Deadlifts, do not rely on just one. Training one exercise will not significantly boost your strength in the other, even if you build muscle. To maximize strength across both knee-flexion and hip-extension movements, you must train both exercises within the same training block.

Commercially available phytosteroid supplements containing 20-hydroxyecdysone (20E) and diosgenin (DSG) provide no additional hypertrophic or performance benefits over resistance training alone because the actual active compound concentrations are drastically lower than labeled amounts.

Do not rely on commercial phytosteroid supplements (specifically those combining 20E and DSG) to boost muscle growth or strength beyond what you achieve through consistent resistance training. This specific study found that the tested product contained less than 1% of the labeled 20E and only 10.4% of the labeled DSG, resulting in no biological activity or performance benefit compared to placebo. Focus on your training and nutrition instead.

When resistance profiles, elbow range of motion, and effort are matched, altering shoulder extension angle (neutral vs. maximally extended) does not produce meaningful differences in elbow flexor hypertrophy in untrained men.

For most recreational lifters, whether you perform bicep curls with your arms by your side (neutral) or slightly behind your torso (extended shoulder) makes no meaningful difference to muscle growth, provided you train to failure and manage the weight similarly. Choose the variation that feels best for your shoulders and allows you to lift consistently. Don't overcomplicate your exercise selection based on shoulder angle alone.

Supplementation with fish protein, vitamin D, and omega-3 fatty acids provides no additional benefit to physical performance adaptations (strength, endurance, workout duration) compared to whey protein or maltodextrin during a 6-week high-intensity functional training (HIFT) program in recreationally trained individuals.

If you are doing high-intensity functional training (like CrossFit), switching to a complex supplement with fish protein, vitamin D, and omega-3s will not give you better strength or endurance gains than taking whey protein or even just carbohydrates (maltodextrin), provided your overall diet is adequate. Focus on consistent training and basic protein intake rather than expensive multi-ingredient stacks for performance enhancement.

Very low-carbohydrate diets (ketogenic) pose long-term sustainability, health, and environmental risks, including potential nutrient deficiencies and increased LDL cholesterol.

Be cautious with very low-carb diets. They can lead to nutrient deficiencies, increased LDL cholesterol, and are difficult to sustain long-term. Focus on balanced, high-quality diets instead.

Handgrip strength reference values for European adults aged 50+ vary significantly by age, sex, and geographic region, with Northern and Western Europe showing higher absolute strength than Southern and Central/Eastern Europe, and standing position yielding higher values than sitting.

If you are over 50, do not compare your handgrip strength to a generic global average. Use the specific reference values for your age group, sex, and European region (Northern, Western, Southern, or Central/Eastern) to accurately assess your muscle health. Standing grip is typically higher than sitting; ensure you are comparing like with like.