Browse the evidence

Bariatric surgery (gastric bypass, sleeve gastrectomy, duodenal switch) is the most effective intervention for significant weight loss and metabolic benefits in severe obesity.

For severe obesity, bariatric surgery (like gastric bypass or sleeve gastrectomy) is the most effective way to achieve significant weight loss. It works by restricting stomach size and/or altering digestion. It also improves metabolic health. Recovery is faster with modern laparoscopic techniques.

Semaglutide 2.4 mg once weekly is a highly effective treatment for obesity, leading to an average 14.9% body weight loss in nondiabetic adults over 68 weeks, and reduces major adverse cardiovascular events (MACE) in patients with obesity without diabetes.

Semaglutide 2.4 mg once weekly is a powerful treatment for obesity. In clinical trials, it helped people lose nearly 15% of their body weight. It also reduces the risk of major cardiovascular events in people with obesity but no diabetes. Discuss with your doctor if this once-weekly injection is right for you.

Older individuals should ingest at least 1.2 g of protein/kg/day to offset muscle atrophy.

Ensure older clients meet protein intake recommendations to support muscle maintenance.

In patients with type 2 diabetes and established cardiovascular disease, GLP-1 receptor agonists or SGLT2 inhibitors with demonstrated cardiovascular benefit are recommended when glycemic goals are not achieved with metformin.

Practitioners should consider GLP-1 receptor agonists or SGLT2 inhibitors for patients with type 2 diabetes who have cardiovascular disease and are not meeting glycemic targets with metformin.

Traditional heavy resistance exercise training increases maximal strength.

Practitioners should incorporate traditional heavy resistance training to enhance maximal strength.

A minimum daily protein intake of ≥1.6 g/kg is necessary to observe significant improvements in muscle mass from whey protein supplementation.

Athletes should ensure their total protein intake meets or exceeds 1.6 g/kg for optimal muscle gain.

Metabolic and bariatric surgeries are the most effective strategy for significant weight loss in people living with severe obesity.

This reinforces the importance of considering surgical options for significant weight loss in severely obese patients.

Weight loss (bariatric) surgery is recommended for patients with a BMI of 40 kg/m2 or higher and for those with a BMI of 35 kg/m2 or greater with at least 1 obesity-related comorbidity.

Practitioners should consider bariatric surgery for eligible patients based on BMI and comorbidities.

Lifestyle interventions, including dietary modifications and increased physical activity, are essential for obesity management.

Practitioners should incorporate lifestyle changes into obesity treatment plans.

For the treatment of obesity, a negative energy balance is crucial.

Weight loss strategies should focus on achieving a negative energy balance.

Bariatric and metabolic surgery (BMS) is the most effective intervention for achieving significant and sustained weight loss, with mean excess weight loss (EWL) of 53% for sleeve gastrectomy (SG) and 63% for Roux-en-Y gastric bypass (RYGB) over 5 years.

Practitioners should consider BMS as a primary option for patients needing significant weight loss.

Most athletes ideally need 1.2 to 2.0 grams/kg of body weight/day of protein, preferably split across 3-4 meals.

Athletes should aim for a specific protein intake range to enhance muscle synthesis and recovery.

Progressive overload is required to keep adapting to training and improving fitness.

Practitioners should implement progressive overload in training regimens.

Bariatric surgery is the most effective long-term treatment for obesity, with an average weight loss of 30-40%.

Bariatric surgery should be considered for eligible patients as a highly effective long-term weight loss solution.

Caloric restriction leads to a significant decrease in body weight in the short term.

Practitioners should consider caloric restriction as an effective short-term strategy for weight loss.

Lifestyle interventions (diet and exercise) remain the most cost-effective and durable strategy for weight loss and diabetes prevention, outperforming microbiome therapies in long-term weight management.

Diet and exercise are the most effective and affordable way to lose weight and prevent diabetes. They outperform probiotics and FMT for weight loss and provide durable benefits.

Regular physical activity (at least 150 minutes/week of moderate-intensity) reduces all-cause and cardiovascular mortality by 20-30% and lowers the risk of type 2 diabetes by 25-35%.

Aim for at least 150 minutes of moderate-intensity aerobic exercise per week (like brisk walking). This reduces your risk of dying from heart disease or other causes by 20-30% and lowers your diabetes risk by 25-35%. If you can't do 150 minutes, start with less; any activity is better than none, and even commuting by bike helps.

For patients with type 2 diabetes and established atherosclerotic cardiovascular disease (ASCVD), sodium-glucose cotransporter 2 (SGLT2) inhibitors or glucagon-like peptide 1 (GLP-1) receptor agonists with proven cardiovascular benefit are recommended as part of glycemic management, regardless of baseline HbA1c.

If you have type 2 diabetes and a history of heart disease (like a heart attack or stroke), your doctor should prioritize medications that protect your heart, specifically SGLT2 inhibitors (like empagliflozin) or GLP-1 agonists (like liraglutide), even if your blood sugar is already reasonably controlled. This is a major shift from older guidelines that focused only on lowering blood sugar numbers.

Total daily protein intake of ~1.6 g/kg/day (up to 2.2 g/kg/day) is the primary determinant of chronic muscle hypertrophy, whereas per-meal timing, dose, and source have negligible impact on long-term muscle accretion if total daily intake is met.

Focus on hitting a total daily protein target of roughly 1.6 grams per kilogram of body weight. This is the most important lever for building muscle. You do not need to obsess over eating protein immediately after your workout or buying expensive 'anabolic' supplements. Simply distribute your daily protein across 3-4 meals to reach this total.

Performing 10 or more sets per muscle group per week maximizes muscle hypertrophy compared to lower volumes, with a clear dose-response relationship observed across <5, 5–9, and 10+ set categories.

To maximize muscle growth, aim for at least 10 sets per muscle group per week. Start with this volume and adjust based on your recovery and progress. If you are short on time, 4 sets per muscle per week will still produce substantial gains, but 10+ is the target for maximum hypertrophy. Periodize your volume, increasing it over months to promote growth, then deload to recover.

Highly effective anti-obesity medications (AOMs), specifically nutrient-stimulated hormone-based therapies (NuSH-BTs) like semaglutide and tirzepatide, induce mean weight loss of 15% or more, significantly outperforming lifestyle interventions alone.

If you have obesity, lifestyle changes alone often result in modest, temporary weight loss. Newer hormone-based medications (like semaglutide or tirzepatide) are highly effective, causing an average 15-20% weight loss. These require a prescription and slow dose titration to manage side effects, but they offer a significant advantage over lifestyle changes alone for achieving substantial health improvements.

For adults with type 2 diabetes and established atherosclerotic cardiovascular disease or high risk, glucagon-like peptide 1 receptor agonists (GLP1RAs) or sodium glucose cotransporter 2 inhibitors (SGLT2is) should be initiated as first-line therapy regardless of baseline HbA1c levels to reduce major adverse cardiovascular events.

If you have type 2 diabetes and heart disease or high heart risk, ask your doctor about GLP-1 agonists (like semaglutide) or SGLT-2 inhibitors (like empagliflozin). These drugs protect your heart and kidneys and are recommended even if your blood sugar numbers look okay. They are often more effective for long-term health than older drugs like metformin alone, though insurance coverage can be a hurdle.

Weight loss of 5-10% achieved through caloric restriction and/or increased physical activity is the first-line, evidence-based treatment for NAFLD, with specific thresholds required for steatosis reduction (≥5%), inflammation improvement (7-10%), and fibrosis improvement (≥10%).

Aim for a 5-10% reduction in body weight through a caloric deficit. You do not need to follow a specific 'liver diet' like Keto or Low-Fat; choose a sustainable healthy pattern (like Mediterranean) that you can maintain. Combine this with at least 150 minutes of moderate exercise per week. Even if you are normal weight, losing 3-5% of your body weight can improve liver fat.

Trans fats (industrial trans-fatty acids) are unequivocally harmful and should be completely avoided as they raise LDL-C, TGs, and Apo B while lowering HDL-C.

Completely avoid industrial trans fats. Check labels for 'partially hydrogenated oils' and avoid fried foods, baked goods, and processed snacks containing them. Opt for fresh, unprocessed foods and healthy cooking oils like olive or canola oil.