Browse the evidence

Yoga interventions significantly reduce serum leptin levels and increase serum adiponectin levels in individuals with obesity or metabolic syndrome.

If you have obesity or metabolic syndrome, incorporating yoga into your routine may help improve your hormonal balance by lowering leptin (which drives hunger) and raising adiponectin (which fights inflammation). For best results, look for programs that combine yoga with dietary changes, as the hormonal benefits appear stronger when diet is also addressed.

Integrating Bluetooth-connected blood glucose meters with popular digital health therapeutics (Noom, Fitbit, Cecelia Health, Welldoc) for 3 months significantly lowers HbA1c in people with type 2 diabetes.

If you have Type 2 Diabetes and struggle with glucose control, using a Bluetooth-connected glucose meter paired with a popular health app (like Noom, Fitbit, or a coaching app) for 3 months can significantly lower your HbA1c. You don't need to test constantly (average 1.5 times/day was effective) or change your medications. The key is choosing an app that fits your lifestyle and engaging with it daily to track your progress and receive feedback.

Long-term semaglutide treatment (0.5–2 mg weekly) induces significant weight loss (up to 14.4%) and appetite suppression in Prader-Willi syndrome (PWS) patients without diabetes, though efficacy is variable and weight regain occurs upon discontinuation.

For PWS patients, semaglutide (0.5-2mg weekly) is a viable option for weight loss and appetite control, even after bariatric surgery. However, results vary, and stopping the drug leads to weight regain. It should be used as a long-term maintenance therapy alongside strict dietary controls, not as a one-time fix.

Short-term intensive insulin therapy improves beta-cell function and insulin sensitivity, increasing the likelihood of achieving type 2 diabetes remission compared to oral hypoglycemic agents alone.

For early-stage Type 2 Diabetes, short-term intensive insulin therapy can help restore your pancreas's ability to produce insulin. This approach is more effective for achieving remission than oral medications alone, though it requires strict adherence and monitoring during the intensive phase.

GLP-1 receptor agonists and GIP analogs show potential for achieving Type 2 diabetes remission through significant weight loss, but current trial data is limited.

For those with overweight or obesity, GLP-1 and GIP-based medications can facilitate significant weight loss, which is a key driver for Type 2 diabetes remission. While trials are still mapping their long-term efficacy for remission, they represent a promising tool for achieving weight loss goals necessary for reversing the disease.

Combining pharmacotherapy with lifestyle interventions (diet/exercise) or bariatric surgery yields superior weight loss and maintenance compared to either intervention alone.

For the best long-term results, do not rely on medication or diet/exercise alone. Use medication to help manage hunger while you establish sustainable diet and exercise habits. This combination is proven to help you keep the weight off after you stop the medication.

Primary Obesity Surgery Endoluminal (POSE) 2.0 and Endomina Gastric Plication are effective endoscopic gastric remodeling techniques that produce significant weight loss and metabolic improvements, though with varying efficacy profiles compared to ESG.

POSE 2.0 and Endomina are endoscopic options that use full-thickness plications to reduce stomach size. They are effective for weight loss and metabolic improvement, though ESG may offer higher weight loss percentages in some studies. They are suitable for patients seeking minimally invasive alternatives to surgery.

Patients taking GLP-1 receptor agonists or dual GIP/GLP-1 agonists should continue these medications through the peri-operative period rather than withholding them, as evidence suggests withholding is insufficient to reduce aspiration risk.

If you take a GLP-1 or GIP/GLP-1 drug (like Ozempic, Wegovy, Mounjaro, Trulicity) for your upcoming elective surgery, do NOT stop taking it. Stopping it for a week or even three weeks does not guarantee your stomach is empty and may not reduce aspiration risk. Instead, tell your anesthesia team you are taking it so they can use specific techniques (like ultrasound or specific intubation methods) to keep you safe.

Patients taking SGLT2 inhibitors should omit these medications the day before and the day of surgery to prevent euglycemic diabetic ketoacidosis (DKA).

If you take an SGLT2 inhibitor (like Jardiance, Farxiga, or Invokana) for your upcoming elective surgery, stop taking it the day before your surgery and do not take it on the day of surgery. This is critical to prevent a rare but serious condition called euglycemic DKA. Your medical team will monitor your blood sugar closely during your stay and manage it with insulin if necessary, which is the safest approach.

AI-driven behavioral weight loss (BWL) interventions using reinforcement learning can achieve weight loss outcomes (approx. 7%) comparable to intensive human coaching but with significantly reduced contact hours (one-third the coaching time).

If you are struggling with the cost or availability of intensive weight loss coaching, look for programs that use AI-driven behavioral coaching. These systems can adapt to your progress in real-time, potentially offering similar weight loss results to intensive human coaching but with less required contact time. Ensure the program uses dynamic feedback (like text or app notifications) rather than just static advice.

Mobile health (mHealth) applications and wearable technology can lead to modest reductions in body weight and BMI, but long-term benefits may diminish once device usage stops, suggesting the Hawthorne effect or need for continuous engagement.

Using a fitness tracker and health app can help you lose a small amount of weight and improve your BMI, but you must use it consistently. If you stop using the device, the benefits may disappear. To make it work, integrate it into your daily routine and consider it a tool for accountability rather than a magic solution.

Dual (GLP-1/GIP) and Triple (GLP-1/GIP/Glucagon) receptor agonists offer superior weight loss and metabolic benefits compared to GLP-1 mono-agonism by leveraging complementary mechanisms.

Newer multi-agonists (dual/triple) like retatrutide show much higher weight loss (up to 24%) than older GLP-1 drugs. They work by hitting multiple metabolic targets at once, which may be necessary for patients who don't respond sufficiently to GLP-1 alone.

In obese patients with preexisting hip or knee osteoarthritis, GLP-1 receptor agonist use is associated with a significantly reduced odds of conversion to total joint arthroplasty (THA and TKA) within one year, independent of weight loss.

If you are obese and have existing hip or knee osteoarthritis, using a GLP-1 receptor agonist (like semaglutide or liraglutide) is associated with a lower risk of needing joint replacement surgery within a year, even if your weight doesn't change significantly. This suggests the drug may have direct protective effects on your joints, not just benefits from weight loss. Discuss this potential benefit with your doctor, especially if you are considering these medications for weight management or diabetes.

Discontinuation of GLP-1 analogues for obesity is primarily driven by side effects (36%), logistical challenges (24%), and cost (23%), leading to significantly lower long-term weight loss compared to persistent users.

If you are taking a GLP-1 for weight loss, sticking with it is the most important factor for success. Most people stop due to side effects, cost, or logistics, not because the drug doesn't work. To stay on it, work with your doctor to titrate the dose slowly to minimize stomach issues, seek financial assistance if the cost is prohibitive, and use telemedicine to reduce logistical burdens. Persisters lose significantly more weight (nearly 18%) than those who quit early (12.6%).

Eloralintide (LY3841136), a selective amylin receptor agonist, promotes significant body weight loss primarily through fat mass reduction with favorable gastrointestinal tolerability compared to non-selective amylin agonists.

Eloralintide is a once-weekly injection that targets specific receptors to reduce appetite and food intake. In early trials, it led to modest but significant weight loss (up to 4.4% in 4 weeks) primarily by burning fat, with fewer stomach side effects than some competitors. It is currently in early clinical stages and not yet widely available.

GLP-1 receptor agonists are cost-effective for expanding access to obesity treatment, particularly for patients ineligible for or hesitant about surgery, and can serve as a bridge to surgery or adjunct for post-surgical regain.

If you cannot have surgery due to health risks, insurance, or wait times, GLP-1 medications are a viable, evidence-based option. They can help you lose enough weight to become a surgical candidate or manage weight after surgery. However, be prepared for lifelong use to maintain results.

GLP-1 receptor agonists (GLP-1RAs) are perceived by current and past users as safe and effective for weight loss, with users strongly disagreeing that risks outweigh benefits, whereas non-users exhibit significant skepticism regarding safety and efficacy.

If you are considering GLP-1RAs, be aware that skepticism about safety and cost are common barriers, especially if you haven't used them. However, data from current and past users shows they strongly disagree that risks outweigh benefits and highly recommend the medication. Consult a healthcare provider to address specific safety concerns and cost barriers, as user experience often contradicts public skepticism.

Glucagon-like peptide 1 receptor agonists (GLP-1RAs) significantly reduce rheumatoid arthritis (RA) disease activity and pain in patients with RA and overweight or obesity, independent of the magnitude of weight loss.

If you have Rheumatoid Arthritis and are overweight, GLP-1 medications (like Ozempic or Mounjaro) may help reduce your joint pain and disease activity, not just help you lose weight. This benefit appears to come from the drug's direct effect on inflammation, not just the weight loss itself. Be aware that stomach side effects are common and insurance coverage can be a hurdle, but the potential for improved RA control is a significant clinical benefit to discuss with your rheumatologist.

Current dietary guidelines (RDA of 0.8 g/kg) may be insufficient for older adults to prevent muscle loss, but exceeding this amount alone does not significantly improve strength or performance without resistance training.

As you age, you might need more protein to maintain muscle, but just eating more protein won't make you stronger. You must combine adequate protein with resistance training to preserve strength and function. Exceeding recommended amounts without exercise offers little extra benefit.

GLP-1 receptor agonists (GLP-1RAs) provide modest antidepressant effects and reduce binge eating behaviors, but their impact on suicidality remains uncertain and potentially elevated in high-risk subgroups.

GLP-1 medications like semaglutide and liraglutide may help with mild depression and binge eating, especially if you have diabetes or obesity. However, if you have a history of severe mental health issues or take other psychiatric meds, monitor your mood closely as there may be a small increased risk of suicidal thoughts. The mental health benefits appear to come from direct brain effects, not just weight loss.

Preoperative optimization with GLP-1 agonists (specifically semaglutide 2.4 mg/week) enables patients with severe obesity (BMI ≥ 35 kg/m²) to achieve target BMI ≤ 35 kg/m², making them eligible for complex abdominal wall repair.

If you have severe obesity and need complex abdominal wall surgery, standard diet and exercise often fail to lower your BMI enough for safe surgery. Using GLP-1 agonists (like semaglutide) for about 8 months can help you lose enough weight (average 11.3%) to meet the safety threshold (BMI ≤ 35) for the procedure. This makes you eligible for surgery that might otherwise be denied or deemed too risky.

In adults with Type 1 Diabetes (T1D) and obesity (BMI ≥27 kg/m²), 12 months of treatment with GLP-1 receptor agonists (tirzepatide, semaglutide, or liraglutide) produces significant weight loss (7.1%–10.9%) without increasing the risk of severe hypoglycemia or diabetic ketoacidosis (DKA).

If you have Type 1 Diabetes and obesity, GLP-1 based medications (tirzepatide, semaglutide, or liraglutide) can help you lose significant weight (7-11%) over a year without increasing your risk of dangerous low blood sugar or DKA, provided your insulin regimen is stable. These drugs also modestly improve blood sugar control and reduce insulin needs.

Among GLP-1/GIP agonists used in Type 1 Diabetes, tirzepatide produces significantly greater weight loss (10.9%) compared to semaglutide (9.9%) and liraglutide (7.1%).

If you have Type 1 Diabetes and obesity, tirzepatide appears to offer the highest weight loss potential (approx. 11%) compared to semaglutide (approx. 10%) and liraglutide (approx. 7%) over 12 months, though all are effective.

GLP-1/GIP agonists reduce daily insulin requirements in Type 1 Diabetes patients by 8.3 to 11.4 units per day over 12 months, likely due to reduced insulin resistance.

Starting GLP-1/GIP agonists in T1D allows you to lower your daily insulin dose by approximately 8-11 units, which may help manage weight and insulin resistance without increasing hypoglycemia risk.