Browse the evidence

Tirzepatide maintenance therapy (either at maximum tolerated dose or reduced to 5 mg) is designed to prevent the weight regain seen with placebo, with rescue protocols available for significant regain.

This paper outlines a trial testing if you can stay on a lower dose of tirzepatide (5mg) or stay on your highest effective dose to keep weight off, compared to stopping it. It also includes a safety net: if you regain more than half your lost weight, you get 'rescue' treatment.

Tirzepatide use is associated with a significantly lower risk of suicidal ideation or suicide attempts compared to other anti-obesity medications in a real-world cohort.

Current real-world evidence suggests that tirzepatide is not associated with an increased risk of suicide and may be associated with a lower risk compared to other anti-obesity medications. However, because this is an observational study, it does not prove causation. Patients with a history of suicidality were excluded, so this data does not apply to high-risk individuals. Consult your provider for personalized psychiatric risk assessment.

GLP-1 receptor agonist therapy for obesity effectively supports weight loss and improves quality of life, but long-term sustainability is undermined by high medication costs, inadequate multidisciplinary support, and significant side effects leading to discontinuation.

GLP-1 medications like Tirzepatide and Semaglutide are effective for weight loss and improving quality of life for many users. However, long-term success is not guaranteed. High costs and side effects are the main reasons people stop treatment. If you are considering or using these medications, be aware that discontinuation often leads to weight regain. Ensure you have a plan for managing costs and side effects, and consider seeking multidisciplinary support (dietary, psychological) to improve adherence and sustainability.

Tirzepatide, a dual GIP/GLP-1 receptor agonist, achieves superior weight loss and hepatic steatosis reduction compared to semaglutide, with preliminary cardiovascular non-inferiority data.

If you have Type 2 Diabetes and fatty liver disease, ask your doctor about Tirzepatide. It is a newer medication that has shown superior weight loss and liver fat reduction compared to other GLP-1 drugs. While cardiovascular outcome data is still being finalized, it is a powerful option for managing both conditions.

Caffeine supplementation, while beneficial for endurance performance, may impair shooting accuracy in biathletes and should be used with caution.

Be cautious with caffeine. While it helps you ski faster, it might make your shooting less accurate. Test it in training to see how it affects your specific shooting performance before using it in competition.

Biathletes should monitor iron and vitamin D levels, as deficiencies are common in endurance sports and can impair performance and health, even if general micronutrient deficiencies are less common in biathletes due to high caloric intake.

Get your iron and vitamin D levels checked regularly. If you are deficient, supplement as directed by your healthcare provider. Focus on iron-rich foods (meat, fish, legumes) and vitamin D sources (sunlight, fortified foods, or supplements if needed).

The menopausal transition is associated with a reduction in lean or muscle mass, with postmenopausal women showing approximately 5.7% lower muscle mass compared to premenopausal women, although this correlation may be confounded by aging and measurement limitations of DXA.

If you are going through menopause, expect a potential decline in muscle mass, particularly during the perimenopausal transition. This is not necessarily inevitable or irreversible. Focus on resistance training and adequate protein intake during this window, as it is a critical period where interventions may be most effective in preventing sarcopenia.

Older women may exhibit elevated fasted muscle protein synthesis (MPS) rates compared to younger women or age-matched men, but their MPS response to anabolic stimuli like resistance exercise or protein ingestion may be blunted.

As you age, your muscles may not respond as strongly to exercise and protein as they did when you were younger. This doesn't mean exercise is useless, but it does mean you may need to be more consistent and potentially adjust your protein intake to maximize muscle protein synthesis.

In 60–65-year-old women, skeletal muscle mass is independently predicted by protein intake per kilogram of body weight, whereas in men of the same age, muscle mass is associated with protein intake and hard leisure-time physical activity, but not other dietary factors.

For seniors aged 60-65, maintaining muscle mass requires sex-specific strategies. Women should focus on adequate protein intake per kg of body weight combined with moderate health-related physical activity, as other nutrients like magnesium and phosphorus also play a role. Men should prioritize total protein intake and engage in harder, vigorous leisure-time physical activity, as other dietary factors do not significantly predict muscle mass in this group.

Regular meal patterns and larger, less frequent meals maximize the Thermic Effect of Food (TEF) compared to irregular or frequent small meals.

Try eating fewer, larger meals rather than grazing throughout the day. Regular, larger meals may trigger a higher thermic effect of food (more calories burned during digestion) and help manage hunger signals better than frequent small snacks.

Garcinia cambogia (Hydroxycitric acid/HCA) supplementation reduces visceral fat and improves fasting blood glucose and insulin sensitivity in overweight/obese individuals.

Garcinia cambogia (HCA) at 1,000 mg/day may help reduce visceral fat and improve blood sugar in overweight people, but it is not a magic bullet. It works by blocking fat synthesis and suppressing appetite.

Coleus forskohlii (Forskolin) supplementation reduces body fat, increases lean mass, and improves insulin sensitivity in overweight/obese men.

Coleus forskohlii (Forskolin) taken daily for 12 weeks may help reduce body fat and increase lean mass in overweight men, improving insulin sensitivity. It works by increasing cAMP, which stimulates fat breakdown.

Banaba leaf extract (Corosolic acid) and Resistant Maltodextrin (RMD) improve blood glucose control and insulin sensitivity through distinct mechanisms.

Banaba leaf extract and Resistant Maltodextrin (RMD) can improve blood glucose control and insulin sensitivity. Banaba works by promoting glucose uptake, while RMD delays carbohydrate absorption and increases SCFA production.

Carriers of the TCF7L2 rs7903146 T allele exhibit significantly attenuated weight loss and metabolic improvements compared to non-T allele (CC) carriers when following a partial meal replacement (pMR) hypocaloric diet.

If you have the TCF7L2 rs7903146 T allele, expect your weight loss to be roughly half as fast as someone with the CC genotype on a similar meal-replacement diet. Focus on metabolic health markers (blood sugar, insulin) as early wins, as these improve significantly even if the scale moves slower.

Animal-based proteins provide a modest but statistically significant advantage in stimulating muscle protein synthesis (MPS) compared to plant-based proteins, primarily driven by higher leucine content and bioavailability.

If you are over 65, prioritize animal proteins (whey, milk, eggs) or ensure your plant protein is high-leucine (soy, pea blends) to maximize muscle growth. For younger adults, plant and animal proteins appear functionally equivalent for MPS when doses are matched.

The MPS advantage of animal proteins over plant proteins is significantly more pronounced in older adults (65+) than in younger adults, likely due to the 'leucine threshold'.

If you are over 65, ensure your plant proteins are high-leucine (e.g., soy, pea) or consider animal proteins to overcome age-related anabolic resistance. Younger adults can likely use either source effectively.

Training the medial gastrocnemius with initial partial repetitions (lengthened position) produces greater hypertrophy than training with past-failure partials (full ROM followed by lengthened partials), although the evidence is currently anecdotal.

If you want to maximize calf growth, prioritize initial partials (stretching the calf at the bottom of the movement) over past-failure partials. Perform full-range calf raises to failure, then immediately drop the heel to stretch the calf and perform partial reps. However, ensure you are eating enough protein (1.6g/kg) and training consistently twice a week. The difference between strategies is small, so consistency with full-range or initial partials is more important than perfect technique.

Short-term increases in energy intake and body weight observed in ultra-processed food (UPF) feeding trials are primarily mediated by higher energy density rather than the processing status itself, and these effects attenuate over time.

Do not demonize ultra-processed foods (UPF) based solely on their processing status. The observed weight gain in short-term studies is largely driven by high energy density, which tends to decrease as the body adapts. If you choose to eat UPF, ensure they are matched for energy density and nutrient quality with less processed options, as no inherent adverse effect on energy intake was found in controlled trials using conservative substitutions.

Among US women, younger age, Black race, lower income, less than 12 years of education, obesity (BMI ≥ 30), and current smoking are significantly associated with reporting both poor diet and low physical activity.

Public health initiatives targeting diet and physical activity should prioritize younger women, Black women, those with lower income and education levels, and current smokers, as these groups show the highest prevalence of combined poor diet and inactivity. Interventions should address socioeconomic barriers rather than assuming uniform access to resources.

GLP-1 receptor agonist therapy initiated at least one year after bariatric surgery produces additional significant weight loss with a favorable safety profile.

If you had bariatric surgery and are struggling with weight regain, GLP-1 medications (like semaglutide or dulaglutide) can help you lose more weight safely. Start with a low dose and work up slowly to minimize stomach issues. Combining the medication with a structured lifestyle program (like the VA's MOVE!) yields the best results.

GLP-1 receptor agonists (GLP-1RAs) improve reproductive outcomes in obese women with PCOS or unexplained infertility by reducing body weight, improving insulin sensitivity, and modulating endometrial immune balance (increasing Treg cells, decreasing pro-inflammatory cytokines, and restoring Th17/Treg balance).

For women with obesity and fertility issues (like PCOS), GLP-1 medications can help restore ovulation and improve the uterine environment by lowering inflammation. However, these drugs must be stopped before you conceive because they can harm the developing embryo. The goal is to use them during the preconception phase to fix metabolic and immune imbalances, then switch to pregnancy-safe management once pregnant.

Semaglutide improves patient-reported pain and function in chronic plantar heel pain, with approximately half of the benefit mediated by weight loss.

If you have chronic heel pain and are overweight or have Type 2 Diabetes, ask your doctor if GLP-1 medications like semaglutide might help. The study suggests these drugs can reduce pain and improve foot function, largely by helping you lose weight, which reduces stress on your feet. This is not a standard treatment yet, so discuss the risks and benefits with your provider.

Metabolic and bariatric surgery (MBS) significantly improves self-esteem, body image, and health-related quality of life, with the greatest gains occurring within the first 12 months post-surgery.

Expect a significant boost in self-esteem and quality of life within the first year after surgery. Be prepared for a period where your external appearance changes faster than your internal self-image, which can cause temporary discomfort.

MBS leads to marked improvements in sexual function for both men and women, including increased libido, erectile function, and hormonal normalization, typically within the first 12 months.

Expect significant improvements in sexual function and hormonal health within the first year after surgery. These changes are driven by weight loss and hormonal recalibration. Address any performance anxiety through counseling to maximize benefits.