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Nutrient-Stimulated Hormone (NuSH) therapies, specifically GLP-1 and dual/triple agonists, significantly improve clinical outcomes and functional capacity in heart failure with preserved ejection fraction (HFpEF) by reducing cardiometabolic burden and systemic inflammation, independent of weight loss alone.

If you have heart failure with preserved ejection fraction (HFpEF) and obesity, current guidelines increasingly support using GLP-1 based therapies (like semaglutide) as a core treatment, not just for weight loss but to protect your heart and kidneys. These drugs work by resetting your metabolism and reducing inflammation, offering benefits that go beyond just shedding pounds. While lifestyle changes are still important, they are often not enough on their own to overcome the body's resistance to weight loss in this specific condition. Consult your cardiologist about whether NuSH therapy is appropriate for your specific phenotype, especially if you have co-existing conditions like sleep apnea or kidney disease.

High-dose once-weekly semaglutide can significantly reduce weight.

Clinicians can consider high-dose semaglutide as an effective option for weight management.

High-dose semaglutide has favorable effects on cardiometabolic risk factors.

High-dose semaglutide may improve patients' overall cardiometabolic health.

Both fasted and fed aerobic exercise groups showed a significant loss of weight (P = 0.0005) and fat mass (P = 0.02) from baseline.

Both fasted and fed aerobic exercise can be effective for fat loss when combined with a caloric deficit.

Body composition changes associated with aerobic exercise in conjunction with a hypocaloric diet are similar regardless of fasting status.

Practitioners can focus on caloric deficit rather than fasting status for body composition goals.

94.2% of patients achieved ≥ 5% weight loss after 6 months of tirzepatide treatment.

Practitioners can expect a high rate of significant weight loss among patients using tirzepatide.

Overall energy balance is the major determinant in weight management.

Practitioners should focus on managing energy balance for effective weight management.

Calories in versus calories out ultimately determines whether weight is gained, lost, or maintained.

Understanding energy balance is crucial for weight management.

The SASI group had greater reductions in A1C, uric acid, low-density lipoprotein, total cholesterol, and triglyceride levels compared to the SG group.

SASI may offer additional metabolic benefits for patients with obesity.

HP diets, whether rich or restricted in red meat, are effective for decreasing body fat.

Practitioners can recommend HP diets, including lean beef, for weight loss.

Consuming lean beef as part of a HP diet does not negatively impact body fat loss compared to a diet restricted in red meats.

Lean beef can be included in HP diets without compromising fat loss.

Body fat percentage and fat mass significantly decreased during the 16-week intervention.

Weight loss interventions can lead to significant reductions in body fat and fat mass.

Participants assigned to a HLC diet experienced a significant 10.6 cm² greater decrease in mean VAT compared to those assigned to a HLF diet from baseline to 6 months.

Practitioners may consider recommending a HLC diet for greater VAT loss in overweight and obese individuals.

Among men, the HLC diet was associated with a 12.1 cm² greater loss of VAT compared to HLF at 12 months.

Men may benefit more from a HLC diet in terms of VAT reduction compared to a HLF diet.

The 5:2 total diet replacement (5:2TDR) resulted in a weight loss of -0.9 kg after 26 weeks, while the once-daily meal-replacement (DMR) group experienced a weight regain of 3.5 kg, leading to a between-group difference of -4.4 kg.

Practitioners may consider recommending 5:2TDR for better weight maintenance outcomes compared to DMR.

Both dietary interventions (5:2TDR and DMR) maintained weight losses greater than 15 kg below baseline at 26, 52, and 78 weeks.

Both interventions can be effective for long-term weight maintenance.

Structured dietary weight-loss maintenance (WLM) is well accepted by participants.

Practitioners can confidently implement these dietary strategies knowing they are well received.

Semaglutide, tirzepatide, and retatrutide achieve placebo-subtracted bodyweight loss of up to 10.8%, 17.8%, and 22.1%, respectively, in adults after 48-72 weeks.

These medications can significantly aid in weight loss for adults with obesity.

Semaglutide reduces body mass index mean by up to 16.7% in adolescents with obesity after 68 weeks.

Semaglutide can be effective for weight management in adolescents with obesity.

Tirzepatide likely results in a greater percentage reduction in body weight from baseline (mean difference -16.03, 95% CI -18.91 to -13.14) compared to placebo.

Practitioners can consider tirzepatide as an effective option for weight loss in adults with obesity.

Tirzepatide likely increases the number of people achieving a 5% weight reduction (risk ratio 3.60, 95% CI 2.44 to 5.30) compared to placebo.

Tirzepatide may be particularly effective for helping patients achieve significant weight loss goals.

At 5-6 months, the mean weight reduction was 7.9%, with 56% of participants achieving more than 5% weight loss.

Phentermine/topiramate ER can be effective for weight loss in obese patients.

At 12 months, patients who persisted in treatment experienced an average weight loss of 9.6%, with 65% surpassing a 5% weight loss.

Long-term adherence to treatment can lead to significant weight loss.

Muscle mass can be significantly preserved by integrating resistance training, adequate protein intake, and body composition monitoring into weight-loss treatment programs.

Incorporating resistance training and proper nutrition can help maintain muscle mass during weight loss efforts.