Browse the evidence

Bupropion and varenicline are effective interventions for reducing tobacco smoking in persons with serious mental illness, with high-strength evidence.

If you have a serious mental illness and smoke, using bupropion or varenicline is a highly effective, evidence-based strategy to quit. This directly addresses a major health-risk behavior that contributes to premature mortality in this population.

Combining basal insulin with a GLP-1 receptor agonist (GLP-1RA) significantly reduces HbA1c, body weight, and hypoglycemia risk compared to basal insulin alone or intensified insulin regimens.

If you are on basal insulin and your blood sugar is still high, ask your doctor about adding a GLP-1 receptor agonist (like liraglutide or dulaglutide). This combination lowers blood sugar more effectively than increasing insulin alone, helps you lose weight, and reduces the risk of low blood sugar episodes.

Bariatric surgery significantly reduces peripheral blood pressure and leads to hypertension remission in a majority of patients with morbid obesity, primarily through weight loss.

For individuals with morbid obesity and hypertension, bariatric surgery (such as gastric bypass) is a highly effective intervention that often leads to the remission of high blood pressure. It is superior to lifestyle changes and medication alone for achieving long-term weight loss and cardiovascular risk reduction in this population.

Overall dietary patterns (e.g., Mediterranean, DASH) are more strongly associated with reduced cardiovascular mortality than focusing on single nutrients or foods.

Adopt a healthy dietary pattern like the Mediterranean or DASH diet, which emphasizes vegetables, fruits, whole grains, and healthy fats, rather than trying to eliminate specific nutrients like fat or sodium in isolation.

Structured, supervised exercise interventions provide mortality and morbidity benefits comparable to pharmacologic interventions for secondary prevention of coronary heart disease, stroke rehabilitation, heart failure treatment, and diabetes prevention.

For chronic conditions, exercise is a primary treatment, not just an adjunct. It reduces mortality and improves function as effectively as drugs. Consult a doctor for a tailored program.

For osteoarthritis of the knee, structured land-based exercise reduces pain and improves physical function with moderate effect sizes, comparable to or better than no-exercise controls.

Land-based exercise reduces knee OA pain and improves function. Supervised exercise is preferable.

Structured, supervised exercise training of at least 12 weeks duration reduces HbA1c levels in type 2 diabetes, with greater reductions seen at durations >150 minutes/week.

For type 2 diabetes, do structured, supervised exercise for at least 12 weeks. Aim for >150 minutes/week for greater HbA1c reduction.

A combined intervention of calorie-reduced low-fat diet and moderate-intensity aerobic exercise produces significantly greater weight loss and body composition improvements than either intervention alone in overweight-to-obese postmenopausal women.

For postmenopausal women aiming for weight loss, combining a calorie-reduced, low-fat diet with moderate-intensity aerobic exercise is the most effective strategy. While exercise alone has limited impact on weight, adding it to a diet plan yields the greatest reduction in body weight and fat mass. Aim for 45 minutes of moderate exercise, 5 days a week, alongside a diet of 1,200-2,000 calories with less than 30% fat.

Aerobic exercise at moderate intensity (150-200 min/week) is the preferred intervention for weight and fat loss in adults with overweight or obesity, though expected weight loss is limited to 2-3 kg on average.

To lose weight, aim for 150-200 minutes of moderate-intensity aerobic exercise (like brisk walking) per week. Manage your expectations: you will likely lose 2-3 kg. This amount of exercise is highly effective for improving blood pressure and visceral fat, even if the scale doesn't move dramatically.

Any type of exercise (aerobic, resistance, combined, or HIIT) improves insulin sensitivity and cardiorespiratory fitness in adults with overweight or obesity.

You don't need to choose just one type of exercise to improve your metabolic health. Whether you walk, lift weights, or do intervals, any of these will improve your insulin sensitivity and heart health. If you try high-intensity intervals, get checked by a doctor first.

Resistance training (RT) combined with a hypocaloric diet is more effective than endurance training (ET) or RT+ET combinations for altering body composition (loss of body mass and fat mass, retention of fat-free mass) and improving metabolic biomarkers (cholesterol, triglycerides, LDL, fasting insulin) in overweight/obese adults.

To lose fat and keep muscle while improving heart health, combine a calorie-reduced diet with resistance training. Lift weights 2-3 times a week, doing 2-3 sets of 6-10 reps at 75% of your one-rep max. This approach is superior to just doing cardio or just dieting for changing your body composition and blood markers.

Pharmacotherapy (Orlistat, Lorcaserin, Phentermine/Topiramate, Naltrexone/Bupropion, Liraglutide) adds 2.5 to 8.9 kg of mean weight loss compared to placebo when used as an adjunct to lifestyle intervention.

If lifestyle changes alone aren't enough, FDA-approved medications can help. These drugs work by reducing hunger or blocking fat absorption. They are meant for long-term use, not quick fixes. Consult a doctor to see if you are a candidate based on your BMI and health history.

Bariatric surgery (Roux-en-Y gastric bypass, sleeve gastrectomy) yields long-term (>3 years) weight reductions of ≥ 20% of initial body weight and decreases morbidity and potentially mortality in patients with severe obesity.

For severe obesity (BMI ≥ 40 or ≥ 35 with health issues), surgery is the most effective option for long-term weight loss (≥ 20% body weight). It reduces health risks and mortality. It is considered when other methods fail.

Once-weekly subcutaneous semaglutide 2.4 mg produces significant weight loss in adults with overweight or obesity regardless of baseline characteristics such as age, race, or baseline BMI, although females and those with lower baseline body weight experience greater magnitude of loss.

Semaglutide 2.4mg weekly, combined with lifestyle changes, is effective for weight loss across diverse demographics. While women and those starting at a lower weight may lose more, men and those with higher starting weights still achieve significant, clinically meaningful weight reduction. Do not skip treatment based on demographics.

Once-weekly subcutaneous semaglutide 2.4 mg combined with lifestyle intervention induces significant weight loss and improves cardiometabolic risk factors in adults with overweight/obesity and type 2 diabetes.

If you have type 2 diabetes and are overweight, adding once-weekly semaglutide 2.4 mg to your diet and exercise routine can lead to significantly more weight loss (about 10% of body weight on average) and better blood sugar control than diet and exercise alone. While you may experience temporary stomach issues, the long-term health benefits are substantial.

Once-weekly subcutaneous semaglutide 2.4 mg combined with lifestyle intervention induces a mean body weight loss of approximately 15% (14.9%) over 68 weeks in adults with overweight or obesity, significantly outperforming placebo.

If you have a BMI of 30 or higher (or 27 or higher with a weight-related health issue), adding once-weekly semaglutide 2.4 mg to your lifestyle changes can help you lose about 15% of your body weight over 16 months. This is significantly more than lifestyle changes alone. Be prepared for possible mild, temporary stomach issues, but the weight loss benefits are substantial and come with improvements in blood pressure and blood sugar.

Once-weekly subcutaneous semaglutide 2.4 mg produces significant weight loss in adults with overweight or obesity, with efficacy largely independent of baseline characteristics such as age, race, BMI, and glycemic status, though females and those with lower baseline body weight experience greater magnitude of loss.

If you have obesity or overweight, once-weekly semaglutide (2.4 mg) is a highly effective treatment for weight loss, regardless of your age, race, or starting weight. However, be aware that women and those with a lower starting body weight tend to lose more weight than men or those with a higher starting body weight. This treatment is used alongside lifestyle changes.

A 4-year intensive lifestyle intervention (diet modification and physical activity) produces sustained weight loss and improvements in cardiovascular risk factors (fitness, glycemic control, blood pressure, HDL-C) in individuals with type 2 diabetes compared to usual care.

For individuals with type 2 diabetes, committing to a structured lifestyle program involving calorie-controlled meals (1200-1800 kcal/day) and at least 175 minutes of moderate exercise per week can lead to significant, sustained weight loss and improved cardiovascular health over several years. Consistency is key, with regular support and monitoring helping to maintain these benefits.

Weight loss achieved through reduced energy intake and increased energy expenditure reduces the risk and severity of obesity-associated diseases (including type 2 diabetes, cardiovascular disease, and cancer) in a dose-related manner, where greater weight loss yields better health outcomes.

To improve your health, you need to create a calorie deficit (eat less, move more). The more weight you lose, the more your risk for diabetes, heart disease, and other obesity-related conditions decreases. Even a modest loss of 5-10% of your body weight provides significant health benefits, even if it doesn't look like a huge change in the mirror. Focus on the health metrics (blood pressure, blood sugar) as much as the scale.

Once-daily subcutaneous liraglutide (2.4–3.0 mg) combined with a 500 kcal/day caloric deficit and exercise counseling sustains significant weight loss (7.8 kg) and improves cardiovascular risk factors (blood pressure, lipids, prediabetes) over a 2-year period in obese non-diabetic adults.

If you are obese and have not been able to lose weight through diet and exercise alone, adding once-daily liraglutide (2.4-3.0 mg) to a moderate caloric deficit (500 kcal/day) and exercise can help you sustain significant weight loss (around 8 kg) and improve your blood pressure and cholesterol over two years. Expect some initial nausea, which usually subsides, and be prepared for daily injections.

Lorcaserin (10 mg once or twice daily) produces significant weight loss and improved glycemic control in patients with type 2 diabetes compared to placebo.

If you have Type 2 Diabetes and struggle with weight, lorcaserin (taken as a 10mg pill once or twice daily) can help you lose about 5% of your body weight over a year, which is significantly more than placebo. It also helps lower your blood sugar (HbA1c). This works best when combined with standard lifestyle changes like eating 600 calories less per day and exercising moderately for 30 minutes a day. Common side effects include nausea and headache, but severe low blood sugar was not observed in this study.

A low-carbohydrate diet produces significantly greater improvements in HDL cholesterol levels compared to a low-fat diet, even when weight loss is equivalent.

If you choose a low-carbohydrate diet, you can expect a significant boost in HDL (good) cholesterol, which is a positive marker for heart health. This benefit persists even if your weight loss is similar to what you'd get from a low-fat diet. Monitor your lipids, but don't let fear of dietary fat prevent you from trying a low-carb approach if it suits your lifestyle.

An intensive lifestyle intervention combining an energy-restricted Mediterranean diet (erMedDiet), physical activity promotion, and behavioral support significantly reduces body weight and improves cardiovascular risk factors in overweight/obese older adults with metabolic syndrome compared to usual care.

To lose weight and improve heart health, combine an energy-restricted Mediterranean diet with regular physical activity and behavioral support. Focus on reducing total calories while increasing healthy fats (olive oil, nuts) and protein. Attend regular support sessions to stay on track. This approach was shown to be more effective than usual care in older adults with metabolic syndrome.

Exercise training reduces visceral adipose tissue (VAT) independently of total body weight loss, whereas hypocaloric diets reduce total body weight but show minimal change in VAT when weight loss is absent.

If your goal is to reduce dangerous belly fat (visceral adipose tissue), exercise is superior to diet alone when you aren't losing weight on the scale. Dieting reduces overall weight but may not specifically target visceral fat if you don't lose weight. Exercise reduces visceral fat significantly (6.1%) even if your total body weight stays the same, likely because it preserves muscle while burning fat. Stop using the scale as your only measure of success; use waist circumference or imaging if possible.