Browse the evidence

Administering tirzepatide (10 or 15 mg once weekly) to adults with overweight or obesity who have already achieved ≥5% weight loss through intensive lifestyle intervention results in substantial additional weight reduction (mean -18.4% from randomization) and prevents weight regain compared to placebo.

If you have successfully lost at least 5% of your body weight through diet and exercise, adding once-weekly tirzepatide (10 or 15 mg) can help you lose an additional ~18% of your body weight and prevent the typical weight regain seen after lifestyle interventions. This approach is particularly relevant if you have obesity-related complications, as it offers superior cardiometabolic benefits compared to lifestyle changes alone.

Semaglutide 2.4 mg improves anthropometric measures (waist circumference, waist-to-height ratio, BMI category) and reduces serious adverse events in patients with obesity and cardiovascular disease, regardless of baseline BMI category.

Semaglutide 2.4 mg not only reduces overall weight but also specifically targets visceral fat (waist circumference) and improves waist-to-height ratio, which are key markers for cardiovascular risk. These benefits, along with a reduced rate of serious adverse events, are consistent across all obesity classes, including those with a BMI just over 30.

Implementing a structured, EHR-driven care process (PATHWEIGH) in primary care mitigates population-level weight gain and increases the likelihood of patients receiving weight-related care, even among those who do not receive direct clinical intervention.

If you are a healthcare system, stop waiting for patients to ask for help. Use your electronic health records to flag patients with high BMI and prompt doctors to discuss weight. Educate your staff that obesity is a chronic disease, not a lifestyle failure. This simple process change can help patients lose weight even if they never see a specialist.

In individuals with type 2 diabetes, a carbohydrate-reduced high-protein (CRHP) diet (30E% carbs, 30E% protein, 40E% fat) induces greater improvements in glycaemic control (HbA1c, diurnal glucose) and reduces liver fat compared to a conventional diabetes diet (50E% carbs, 17E% protein, 33E% fat), even when both diets produce matched weight loss.

For a person with Type 2 Diabetes, switching to a diet with 30% of calories from carbs, 30% from protein, and 40% from fat (while maintaining a calorie deficit to lose weight) can improve blood sugar control and reduce liver fat more effectively than a standard high-carb diabetes diet, even if both diets result in the same amount of weight loss. However, be aware that this diet may not reduce fat stored in the pancreas as much as a standard diet.

Training adaptations (e.g., VO2max, strength) vary greatly between individuals, necessitating monitoring and re-planning for non-responders.

Don't assume a standard program works for everyone. Track your progress (e.g., weight lifted, running pace). If you aren't improving after a few weeks, increase the dose or change the exercise. Personalization through monitoring is key.

Long-acting GLP-1 receptor agonists significantly reduce glycated hemoglobin (HbA1c) levels and body weight in adults, with greater efficacy observed in patients with type 2 diabetes compared to non-diabetic overweight individuals.

Long-acting GLP-1 receptor agonists (like semaglutide or liraglutide) are effective for lowering blood sugar and reducing body weight in adults. The effect is more pronounced in people with type 2 diabetes. Common side effects include gastrointestinal issues, which may vary by individual. Consult a healthcare provider to determine if these medications are appropriate for your specific health profile.

There is a negative correlation between glycemic control (HbA1c reduction) and body weight reduction at the between-study level in all participants, but a positive correlation exists when analyzing patients with diabetes or non-diabetic participants separately.

For people with diabetes, GLP-1 RAs tend to improve both blood sugar and weight loss together. For non-diabetic individuals, these drugs still cause weight loss, but this may not translate to improved blood sugar markers since their levels are already normal. The relationship between weight loss and glycemic control is complex and depends on your starting health status.

A comprehensive behavioral weight loss intervention (diet, physical activity, and behavioral therapy) improves asthma control in obese adults with suboptimally controlled persistent asthma.

If you are obese and have asthma that is hard to control, losing about 7% of your body weight through a structured program of diet, exercise, and behavioral coaching can significantly improve your asthma control. The program involves weekly group sessions for the first four months, followed by monthly check-ins, focusing on gradual weight loss and 150 minutes of moderate exercise per week.

GLP-1 receptor agonists (semaglutide, tirzepatide) and bariatric surgery produce substantial weight loss (>10-15%) and improve cardiometabolic risk factors, but weight regain is common upon discontinuation, often necessitating lifelong treatment.

GLP-1 medications and surgery are currently the most effective tools for significant weight loss and metabolic improvement. However, they are not 'cures'; stopping them typically leads to weight regain. If you choose this path, prepare for it to be a long-term or lifelong commitment, and verify insurance coverage or affordability before starting.

Bariatric surgery is recommended for individuals with BMI ≥ 40 kg/m2, or BMI ≥ 35 kg/m2 with comorbidities, to achieve long-term weight loss, diabetes remission, and reduced mortality.

If you have a BMI of 40 or higher, or 35 or higher with health issues like diabetes or high blood pressure, bariatric surgery is a highly effective option. It leads to greater long-term weight loss and diabetes remission than medical treatment alone, and reduces long-term mortality. Discuss this with a specialist to see if you are a candidate.

A 12-week smartphone app intervention promoting overall healthy eating habits (focusing on food patterns rather than specific nutrients) improves dietary intake and clinical markers in patients with type 2 diabetes.

Use a dedicated health app for 12 weeks that guides you through one healthy eating topic per week (like vegetables or sugar). The app provides daily reminders and feedback. This structured, behavior-focused approach is designed to help you build sustainable healthy habits without needing to count specific nutrients.

Testosterone therapy in older men with low testosterone and symptoms improves sexual function, anemia, and bone mineral density, and prevents type 2 diabetes in high-risk men, while demonstrating cardiovascular safety in large RCTs.

If you are an older man with low testosterone and symptoms, testosterone therapy can improve sexual function, blood counts, and bone density. For those at high risk of diabetes, it significantly reduces that risk. Large recent studies confirm it is safe for the heart and prostate, so discuss this with your doctor if you meet the criteria.

Weekly subcutaneous semaglutide (titrated to 2.0 mg) significantly reduces body weight in clozapine-treated patients with schizophrenia and obesity compared to placebo over 36 weeks.

This protocol outlines a clinical trial for using semaglutide to treat obesity in people with schizophrenia taking clozapine. It is not a general recommendation but a research study. If you are interested, consult your psychiatrist about eligibility for clinical trials, as this specific intervention is currently under investigation for this population.

A phone-based intervention using Motivational Interviewing (MI) principles delivered by a trained nurse significantly improves adherence to Continuous Positive Airway Pressure (CPAP) therapy in patients with Obstructive Sleep Apnea Syndrome (OSAS) compared to usual care alone.

If you have sleep apnea and are struggling to use your CPAP machine, standard instructions might not be enough. This study suggests that talking with a nurse who uses Motivational Interviewing techniques—focusing on your reasons for wanting to get better and building your confidence—can help you stick with the therapy longer. The key is personalized support: if you are struggling early on, you get more frequent check-ins to help you overcome barriers.

A Low Carbohydrate Diet (LCD) with 12% carbohydrate intake normalizes glucose variability and significantly reduces average blood glucose levels in patients with Type 2 Diabetes Mellitus within two weeks.

For a patient with uncontrolled Type 2 Diabetes, switching to a strict Low Carbohydrate Diet (approx. 12% carbs) can rapidly lower average blood glucose and reduce daily spikes within days. This approach prioritizes hormonal regulation (insulin sensitivity) over simple calorie counting, though it requires medical supervision to manage ketone levels and medication adjustments.

The efficacy of protein supplementation on fat-free mass gains is moderated by age and training status: it is more effective in resistance-trained individuals and less effective in older adults (>45 years).

If you are experienced in resistance training or are over 45, protein supplementation is particularly important for maximizing muscle gains. Novices and younger individuals may see smaller relative benefits from supplementation if their baseline intake is already adequate.

Obesity pharmacotherapy reduces the risk of major adverse cardiovascular events (MACE) in patients with established atherosclerotic cardiovascular disease (ASCVD) and BMI ≥ 27, independent of diabetes status.

If you have heart disease and are overweight (BMI ≥ 27), ask your doctor about semaglutide (Wegovy). It has been proven to reduce the risk of heart attacks and strokes, in addition to helping with weight loss.

Replacing saturated fatty acids (SFA) with monounsaturated (MUFA) and polyunsaturated fatty acids (PUFA) reduces cardiovascular risk, with the specific benefit depending on the parent food source rather than the fatty acid in isolation.

Prioritize replacing saturated fats (butter, processed meats) with monounsaturated fats (olive oil) and polyunsaturated fats (seeds, fatty fish). Do not fear total fat intake if it comes from these healthy plant and marine sources.

Consuming fatty fish at least twice per week to achieve at least 250 mg/day of marine n-3 PUFA (EPA/DHA) is cardioprotective.

Eat fatty fish (like salmon or mackerel) at least twice a week to get enough heart-healthy omega-3s.

n-6 polyunsaturated fatty acids (PUFA) are cardioprotective, and increasing consumption of vegetable sources (seeds, derived oils) is encouraged to meet the 5-10% energy recommendation.

Increase intake of seeds and vegetable oils to ensure you get enough n-6 fats, which protect heart health.

Intensive health guidance using Internet of Things (IoT) devices providing real-time feedback from healthcare professionals improves glucose control (HbA1c) in type 2 diabetes outpatients compared to conventional self-management without feedback.

This paper describes a protocol for a digital health intervention. It suggests that using connected devices (scales, BP monitors, activity trackers) that transmit data to a doctor or health coach, who then provides monthly feedback, is a method being tested to improve blood sugar control in type 2 diabetes. The results of this specific study are not yet published.

Semaglutide subcutaneous (SQ) at 2.4 mg produces the greatest weight loss among GLP-1 analogs, significantly outperforming other agents including lower-dose semaglutide and liraglutide.

If you are seeking the most effective pharmacological weight loss treatment available in this class, semaglutide administered subcutaneously at 2.4 mg is the superior choice. It produces significantly greater weight loss than other GLP-1 analogs like liraglutide or lower-dose semaglutide. Be aware that this higher efficacy comes with a higher risk of gastrointestinal side effects, though it is not the highest risk among all GLP-1 agents.

Older adults (median age > 58.8 years) derive significantly greater improvements in physical functioning from intensive lifestyle interventions than younger adults with Type 2 Diabetes.

If you are over 60 with Type 2 Diabetes, an intensive lifestyle program is particularly powerful for you. You are likely to see bigger improvements in your daily physical function (mobility, independence) than younger patients because you start with more room for improvement. Don't let age discourage you; it may be your greatest asset for seeing functional gains.

Avoidance of sugar-sweetened beverages (SSBs) is recommended to reduce the risk of weight gain and worsening cardiometabolic risk profiles in people with diabetes.

Stop drinking sugar-sweetened beverages (soda, sweet tea, energy drinks, fruit drinks with added sugar). This helps prevent weight gain and improves heart health. If you miss the sweetness, you can substitute with non-nutritive sweeteners, but be mindful not to overcompensate with other foods.