Browse the evidence

Wearing a weight vest loaded to 11% of body weight for 8 hours daily over 5 weeks significantly reduces fat mass and waist circumference while increasing lean mass in individuals with obesity, independent of changes in energy expenditure or physical activity levels.

To improve body composition, wear a weight vest loaded to 11% of your body weight for 8 hours a day for 5 weeks. You do not need to change your diet or increase your exercise routine; the mechanical load itself drives fat loss and muscle gain. Focus on standing as much as possible while wearing the vest. Expect some initial musculoskeletal discomfort, but this does not negate the benefits.

Weekly subcutaneous semaglutide (2.4 mg) combined with lifestyle interventions produces clinically significant weight loss (mean -14.9%) in adults with obesity, outperforming daily liraglutide (3.0 mg) in magnitude and duration of effect.

If you have obesity, weekly semaglutide injections (2.4 mg) combined with diet and exercise can help you lose nearly 15% of your body weight. This is significantly more effective than daily liraglutide. Start with a low dose to minimize nausea, and stick with it, as the benefits persist longer than other treatments.

Tirzepatide 15 mg administered once weekly for 72 weeks is the most cost-efficient intervention for achieving high-magnitude weight loss targets (15% and 20%) in adults with obesity, yielding a cost per kilogram of weight loss of £89.24.

For adults with obesity seeking significant weight loss, the 15mg weekly dose of tirzepatide, combined with diet and exercise, offers the best value for achieving major weight reduction goals (15-20%) over 72 weeks, despite higher initial drug costs, due to superior efficacy and potential long-term healthcare savings.

Tirzepatide 10 mg is the most cost-efficient dose for achieving moderate weight loss targets (10% and 15%) and provides competitive outcomes for BMI improvement compared to 5mg and 15mg doses.

For patients targeting moderate weight loss (10-15%), the 10mg weekly dose of tirzepatide offers a strong balance of efficacy and cost-efficiency, often outperforming lower doses and competing well with higher doses for BMI improvements.

Supervised combined exercise and dietary interventions significantly improve glycaemic control, comorbidities, and quality of life in Type 2 Diabetes Mellitus (T2DM) patients, with supervised exercise yielding superior outcomes to unsupervised regimens.

Do not rely on unsupervised exercise alone for T2DM management. Engage in a supervised exercise program combined with a personalized dietary plan (such as the Mediterranean diet). Supervised exercise has been shown to significantly improve blood sugar, blood pressure, cholesterol, and weight loss compared to unsupervised efforts.

GLP-1 receptor agonists (GLP1-RA), particularly long-acting formulations, provide superior glycaemic control, weight loss, and cardiovascular risk reduction compared to short-acting GLP1-RA, and are recommended for chronic weight management and MACE reduction.

Long-acting GLP-1 receptor agonists (like semaglutide or liraglutide) are highly effective for T2DM and weight loss. They offer better glycaemic control and fewer hypoglycemic episodes than short-acting versions. If you dislike injections, oral semaglutide is an effective alternative.

For untrained older adults engaging in resistance training, a daily protein intake of 1.6 g/kg body weight significantly increases skeletal muscle mass and strength compared to the standard recommendation of 0.8 g/kg, without causing adverse effects on liver or kidney function.

If you are an older adult starting resistance training, aim for 1.6 grams of protein per kilogram of body weight daily. Spread this out across your meals (e.g., 0.4 g/kg per meal) to maximize muscle growth. This amount is safe for your kidneys and liver if you are healthy, and it will help you build more muscle and strength than the standard recommendation of 0.8 g/kg.

Beta-alanine and creatine significantly improve jump performance in athletes, with beta-alanine showing a marginally higher effectiveness ranking.

To improve your vertical jump, consider supplementing with beta-alanine or creatine alongside your training. Beta-alanine showed a slightly higher effectiveness ranking in this analysis. Ensure you are consistently training with strength and conditioning protocols.

Creatine supplementation significantly improves sprint speed in athletes, while beta-alanine and vitamin D do not.

If your sport relies on short sprints, creatine supplementation combined with training is likely to improve your speed. Beta-alanine and vitamin D did not show significant benefits for sprint speed in this analysis.

Composite meals with high fiber, low total fat, and minimal processing elicit significantly lower postprandial metabolic stress (GlucoTRIG index) compared to meals high in fat and refined foods, despite similar caloric content.

To minimize metabolic stress after a meal, prioritize high-fiber, low-fat whole foods (like beans, vegetables, and fruits) over processed foods high in fat, even if the high-fat meal has fewer carbohydrates. A meal with 58% carbohydrates but high fiber and low fat (like the study's Meal 3) was metabolically healthier than meals with lower carbohydrates but higher fat content.

Community-based cardiovascular disease (CVD) preventive interventions significantly reduce daily energy intake, fat percentage, and saturated fat percentage, while increasing fiber intake.

To improve your diet for heart health, look for community programs that offer active coaching and education, not just pamphlets. These programs successfully help people eat fewer calories, less saturated fat, and more fiber. The key is active participation and support, not just reading advice.

Interventions using tailored individual lifestyle coaching and interactive group sessions are more effective than those using only passive materials like pamphlets or text messages.

For lasting dietary changes, seek programs that offer personal coaching and group interaction. Simply reading pamphlets or receiving text messages is unlikely to be enough. Look for programs that involve trained professionals and interactive sessions.

Newer anti-obesity medications (GLP-1 and GLP-1/GIP agonists like semaglutide and tirzepatide) produce significantly greater weight loss (15-22.5%) compared to lifestyle modifications alone, which typically yield modest and unsustainable results.

Newer GLP-1 and GLP-1/GIP medications (like semaglutide and tirzepatide) are significantly more effective for weight loss (15-22.5%) than lifestyle changes alone. However, access is difficult due to insurance coverage, supply shortages, and cost. These medications should be viewed as a tool to help manage obesity as a chronic disease, but they still require lifestyle support and are not a 'magic pill' without side effects or administrative burdens.

Weight loss, achieved through lifestyle changes, medications, or bariatric surgery, is associated with significant improvements in OSA severity, with a 20% BMI reduction leading to an average 57% decrease in AHI.

Losing weight is one of the most effective ways to reduce OSA severity. If you lose 20% of your body weight, your sleep apnea severity (AHI) can decrease by an average of 57%. This can be achieved through lifestyle changes, medications like tirzepatide, or bariatric surgery, and offers cardiovascular benefits that PAP alone may not provide.

GLP-1 receptor agonists (semaglutide and tirzepatide) are effective treatments for weight regain after bariatric surgery, producing clinically significant weight loss without severe adverse events.

If you regain weight after sleeve gastrectomy, GLP-1 medications like semaglutide or tirzepatide are effective and safe options to help you lose it back, avoiding the need for high-risk revisional surgery.

Tirzepatide (15 mg once weekly) combined with lifestyle counseling produces a mean weight loss of 20.9% over 72 weeks in patients with obesity or overweight.

If you are prescribed Tirzepatide (Zepbound), expect to take a 15 mg injection once weekly. This works best when combined with a 500 kcal daily caloric deficit, physical activity, and lifestyle counseling. Be prepared for potential gastrointestinal side effects like nausea, which can often be managed by eating smaller meals.

Semaglutide (2.4 mg once weekly) produces a mean weight loss of 14.9% over 68 weeks in patients with obesity without diabetes.

If you are prescribed Semaglutide (Wegovy), expect to take a 2.4 mg injection once weekly. This can lead to a 14.9% reduction in body weight over 68 weeks. Be prepared for potential gastrointestinal side effects like nausea, which can often be managed by eating smaller meals.

Liraglutide (3 mg once daily) produces a mean weight loss of 8% over 56 weeks in patients without diabetes.

If you are prescribed Liraglutide (Saxenda), expect to take a 3 mg injection once daily. This can lead to an 8% reduction in body weight over 56 weeks. Be prepared for potential gastrointestinal side effects like nausea, which can often be managed by eating smaller meals.

Subcutaneous semaglutide (up to 1.0 mg once-weekly) produces significantly greater reductions in BMI and waist circumference compared to liraglutide (up to 3.0 mg once-daily) in obese patients with type 2 diabetes over a 12-month period, while both agents significantly lower HbA1c.

For obese patients with type 2 diabetes, switching from or choosing semaglutide over liraglutide is likely to result in greater weight loss and waist circumference reduction. While both drugs effectively lower blood sugar, semaglutide offers superior body composition benefits. Patients should be aware that gastrointestinal side effects are common, especially with semaglutide, but these often subside as the dose is titrated up.

Obesity pharmacotherapy (GLP-1/GIP agonists) reduces body weight with minimal loss of lean mass and improves cardiovascular outcomes, potentially mitigating the adverse effects of intermittent fasting.

If you are considering obesity pharmacotherapy (like GLP-1 agonists), know that it can lead to significant weight loss (up to 21% in some trials) with minimal loss of muscle mass, which is a key advantage over intermittent fasting. It also reduces cardiovascular risk. However, long-term safety is still being studied, and combining it with lifestyle changes (diet and exercise) is recommended for the best outcomes.

Performing past-failure partial repetitions in the lengthened position after reaching momentary failure during standing calf raises increases medial gastrocnemius hypertrophy compared to terminating sets at momentary failure in peak plantarflexion.

If you do calf raises, don't stop when you can no longer lift your heels all the way up. Once you fail a full repetition, immediately drop the heel as low as possible and do partial up-and-down movements until you can't lift your heels to that lowest point anymore. This adds significant volume and tension to the muscle, leading to more growth than stopping at the point of failure. Expect it to be uncomfortable, but for many, the extra growth is worth it.

Resistance training improves handgrip strength in older adults with sarcopenia, with an optimal dose of 3 sessions/week at 49% 1RM, 19 weeks duration, 15 exercises, 16 reps, 6 sets, totaling 1,400 reps/week.

If you are an older adult with sarcopenia, aim for 3 resistance training sessions per week. Use a weight that feels like 49% of your maximum lift (moderate effort). Perform 15 different exercises, doing 6 sets of 16 repetitions for each. Keep your total weekly repetitions around 1,400. Stick to this plan for 19 weeks to see the best improvement in your handgrip strength.

Fasting interventions significantly reduce liver health biomarkers (ALT and liver stiffness) in individuals with MASLD compared to control diets.

For those with MASLD, structured fasting approaches (like Alternate Day Fasting, 5:2 diets, or Time-Restricted Eating) have been shown in meta-analyses to significantly lower liver enzymes (ALT) and reduce liver stiffness compared to control diets. These benefits are linked to improvements in insulin resistance and triglyceride levels. Most effective studies lasted 3 months, so long-term sustainability needs more research, but the short-term liver health gains are robust.

The Mediterranean Diet (MedDiet) significantly improves liver health biomarkers (ALT, liver stiffness, and MRI-PDFF) in individuals with MASLD.

Adhering to a Mediterranean Diet significantly improves liver health in people with MASLD, lowering liver enzymes, reducing liver stiffness, and decreasing liver fat content. Studies lasted from 3 to 24 months, showing consistent benefits. This dietary pattern is a strong, evidence-based first-line approach for managing liver health.