Browse the evidence

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.

SGLT2 inhibitors and GLP-1 receptor agonists provide significant cardiovascular risk reduction and should be considered first-line therapy for patients with type 2 diabetes and established cardiovascular disease.

If you have Type 2 Diabetes and existing heart disease, ask your doctor about SGLT2 inhibitors (like empagliflozin) or GLP-1 receptor agonists (like semaglutide). These drugs are now considered first-line because they protect your heart and reduce the risk of heart attack and stroke, in addition to controlling blood sugar. This is more important than just lowering your A1C number.

Lifestyle intervention (diet, physical activity, behavioral changes) is the cornerstone of obesity treatment and should be initiated in all patients, regardless of whether pharmacotherapy or surgery is added.

Start with lifestyle changes: diet, exercise, and behavior. This is the base for everyone. If you need medication or surgery, it only works well if you keep doing these lifestyle changes.

Resistance exercise is the only intervention capable of consistently restoring muscle function and strength in sarcopenia, partially overcoming age-related anabolic resistance.

You must lift weights to regain strength and function. Aim for 2-3 sessions per week at a moderate-to-vigorous intensity (70-85% of your max). This mechanical load is the key signal your body needs to rebuild muscle function, which nutrition alone cannot provide.

Lifestyle interventions (diet, exercise, weight loss, smoking cessation) significantly reduce the risk of developing Type 2 Diabetes, cardiovascular disease, and chronic kidney disease progression.

Adopting a healthy lifestyle is the most powerful tool for preventing heart, kidney, and metabolic disease. Focus on a balanced diet, regular physical activity (aiming for 150 minutes per week), maintaining a healthy weight, and quitting smoking. These changes can reduce your risk of developing diabetes by up to 72% and significantly lower your cardiovascular risk.

Semaglutide (2.4 mg once weekly) and Tirzepatide (up to 15 mg once weekly) produce significant weight loss (up to 14.9-20.9%) and improved glycemic control (HbA1c reduction >2%) in adults with obesity or type 2 diabetes, outperforming placebo and existing pharmacotherapies.

Semaglutide and Tirzepatide are highly effective, once-weekly injectable treatments for obesity and type 2 diabetes. They work by mimicking hormones that regulate appetite and blood sugar, leading to significant weight loss (up to 20%) and better glucose control than most other drugs. Because weight regain is common after stopping, these medications are intended for long-term management of these chronic conditions, not short-term fixes.

Once-weekly subcutaneous semaglutide 2.4 mg, used as an adjunct to behavioral intervention, produces substantial and sustained weight loss (mean -15.2%) and improves cardiometabolic risk factors in adults with obesity or overweight with comorbidities over 104 weeks.

If you have obesity or overweight with a related health issue, adding once-weekly semaglutide 2.4 mg to your diet and exercise plan can help you lose about 15% of your body weight over two years. This is significantly more than diet and exercise alone. Expect some stomach issues like nausea at first, but they usually get better. You need to keep taking the medication to keep the weight off.

Tirzepatide, a dual GIP/GLP-1 receptor agonist, produces significantly greater reductions in BMI, waist circumference, and body weight compared to GLP-1 receptor agonists (semaglutide, dulaglutide), insulin, and placebo in patients with obesity or type 2 diabetes.

Tirzepatide is a once-weekly injectable medication that activates two gut hormones (GIP and GLP-1) to significantly reduce body weight and waist circumference. Clinical data shows it is more effective than existing GLP-1 drugs (like semaglutide), insulin, and placebo. It is prescribed for adults with obesity or type 2 diabetes, often starting at a low dose (2.5 mg) and increasing to 5, 10, or 15 mg to minimize side effects. Common side effects include nausea and diarrhea, which are usually mild and temporary. It should be used alongside diet and exercise.

Tirzepatide produces substantial, dose-dependent weight loss in non-diabetic adults with obesity, with maximum tolerated doses achieving mean body weight reductions of approximately 20.9% compared to placebo.

If you have obesity and do not have diabetes, tirzepatide is a highly effective pharmacological intervention for weight loss. The medication works by mimicking hormones that regulate appetite and metabolism. Higher doses (up to the maximum tolerated dose) yield greater weight loss, with some patients losing over 20% of their body weight. While gastrointestinal side effects like nausea are common, they do not appear to increase the risk of serious health events compared to a placebo, making it a viable option for chronic weight management.

GLP-1 receptor agonists (liraglutide, semaglutide, tirzepatide) produce significant, clinically meaningful weight loss (7–21%) and improve cardiometabolic markers in adults and adolescents with obesity.

If you have obesity, GLP-1 medications like semaglutide or tirzepatide are currently the most effective pharmacological tools available, producing weight loss comparable to bariatric surgery. They work by mimicking hormones that regulate appetite and digestion. While they require weekly (or daily) injections and can cause temporary gastrointestinal side effects, they also improve blood pressure, blood sugar, and cholesterol. Because obesity is a chronic disease, these medications are intended for long-term use to maintain weight loss, not just short-term fixes.

Discontinuation of GLP-1 receptor agonist therapy leads to substantial weight regain, indicating that obesity requires long-term, possibly lifelong, pharmacological management.

If you stop taking GLP-1 medications like semaglutide, you will likely regain most of the weight you lost. This is because obesity is a chronic condition, and the medication helps manage the underlying hormonal drivers. To keep the weight off, you likely need to stay on the medication long-term, similar to how blood pressure medication is used for hypertension.

Tirzepatide, a dual GIP/GLP-1 receptor co-agonist, produces significantly greater reductions in HbA1c and body weight compared to selective GLP-1 receptor agonists (semaglutide) and basal insulin in patients with type 2 diabetes.

If you have Type 2 Diabetes, Tirzepatide offers the highest level of blood sugar and weight loss control currently available in injectable medications, surpassing other popular GLP-1 drugs. It works by mimicking two natural gut hormones. The key to success is starting with a very low dose and increasing it slowly every few weeks to minimize stomach upset, which is the main reason people stop taking these drugs.

Adhering to national dietary guidelines using minimally processed foods (MPF) results in significantly greater weight loss and fat mass reduction compared to adhering to the same guidelines using ultraprocessed foods (UPF), primarily driven by lower energy intake.

If you want to lose weight, follow your country's official healthy eating guidelines. Doing so with minimally processed foods (like whole grains, fresh fruits, and vegetables) will help you lose more weight than doing so with ultraprocessed foods (like reformulated cereals and ready meals). However, even if you eat ultraprocessed foods, as long as they meet national nutritional standards (low sugar, salt, and fat, high fiber), you can still lose weight. The key is that minimally processed foods help you eat fewer calories naturally, likely because they are less energy-dense and take longer to eat.

Tirzepatide and semaglutide are the only obesity management medications (OMMs) achieving greater than 10% total body weight loss (TBWL) at study endpoints, with tirzepatide uniquely associated with a significantly higher proportion of patients achieving ≥25% TBWL.

If you are seeking significant, clinically meaningful weight loss (over 10% of body weight), current evidence strongly supports using tirzepatide or semaglutide over older oral medications. Tirzepatide shows the highest efficacy, with a unique ability to help a larger proportion of patients lose 25% or more of their body weight. Be aware that these are long-term treatments; stopping them typically leads to regaining most of the lost weight, so they should be viewed as ongoing management for obesity, not a short-term fix.

Once-weekly subcutaneous 2.4 mg semaglutide induces clinically meaningful, sustained double-digit weight loss (average ~15-16%) in adults with obesity or overweight, significantly outperforming previous pharmacotherapies and approaching results of metabolic surgery.

For adults with obesity or overweight plus a comorbidity, once-weekly 2.4 mg semaglutide is a highly effective treatment that produces an average 15-16% weight loss, which is significantly better than previous drugs and lifestyle changes alone. It requires a weekly injection, titrated up over 4 months to minimize side effects, alongside a modest calorie deficit and exercise. While GI side effects are common, they are usually manageable.

Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) are more effective than adjustable gastric banding (AGB) for weight loss and quality of life in severe obesity, with RYGB providing superior weight loss compared to SG.

If you have severe obesity and are considering surgery, Roux-en-Y gastric bypass offers the best chance for significant, lasting weight loss and improved quality of life. Sleeve gastrectomy is a good alternative if bypass is not possible, but expect less weight loss. Adjustable gastric banding is not recommended as it is significantly less effective. Discuss these options with a specialist bariatric team to determine the best fit for your health profile.

Tirzepatide induces significant, dose-dependent weight loss in patients with obesity or type 2 diabetes, with non-diabetic individuals experiencing greater absolute weight reduction than diabetic individuals at equivalent doses.

Tirzepatide is a highly effective treatment for weight loss, with higher doses (15 mg) producing the greatest results. Non-diabetic patients tend to lose more weight than diabetic patients at the same dose. The most common barrier is gastrointestinal side effects like nausea, which are dose-dependent but typically manageable and do not lead to serious health risks.

Tirzepatide increases the likelihood of achieving clinically meaningful weight loss thresholds (≥5%, ≥10%, ≥15%) in a dose-dependent manner, with 15 mg showing the highest odds ratios for all thresholds.

Higher doses of tirzepatide significantly increase your chances of losing 5%, 10%, or 15% of your body weight. The 15 mg dose offers the highest probability of achieving these milestones compared to lower doses.

Semaglutide (2.4 mg weekly) produces significantly greater weight loss than liraglutide (3.0 mg daily), orlistat, and phentermine in obese individuals.

If you have obesity or overweight with related health risks, Semaglutide (2.4 mg weekly) is currently the most effective pharmacological option for weight loss, significantly outperforming Liraglutide, Orlistat, and Phentermine. You must start at a low dose (0.25 mg) and increase it every 4 weeks to minimize stomach side effects. This medication works best when combined with diet and exercise changes.

Once-weekly subcutaneous semaglutide at 2.4 mg is effective and safe for weight loss in non-diabetic adults and adolescents with overweight or obesity, demonstrating superiority over both placebo and daily liraglutide.

For non-diabetic adults and adolescents with obesity, once-weekly subcutaneous semaglutide (2.4 mg) combined with lifestyle changes is a highly effective treatment for significant weight loss. It is superior to placebo and daily liraglutide. While gastrointestinal side effects like nausea are common, they often subside over time. This treatment is FDA-approved and supported by robust clinical trials.

Tirzepatide, a dual GIP/GLP-1 receptor agonist, produces significant, dose-dependent weight loss and HbA1c reduction in overweight and obese adults with type 2 diabetes, with efficacy increasing at doses of 5mg, 10mg, and 15mg administered once weekly.

If you have type 2 diabetes and are overweight or obese, Tirzepatide is a highly effective, once-weekly injection that helps you lose significant weight and lower your blood sugar. The higher the dose (up to 15mg), the more weight you tend to lose. While you might experience side effects like nausea or diarrhea, especially at higher doses, most people get used to it. It is more effective than many existing obesity medications.