Browse the evidence

Plasma Branched-Chain Amino Acid (BCAA) levels are significantly associated with lower body fat percentage and higher lean mass percentage in sedentary adults undergoing protein supplementation and exercise.

Higher levels of BCAA in your blood are linked to less body fat and more lean muscle in people who supplement protein and exercise. This suggests that ensuring adequate BCAA intake (via protein) is important for optimizing body composition.

Anti-obesity medications (AOMs) are significantly underutilized in clinical practice, with only 1.4% of eligible patients receiving prescriptions despite nearly half of the adult population meeting eligibility criteria.

If you are eligible for anti-obesity medications based on your BMI and health conditions, you are not currently receiving them in most cases. This is not necessarily a reflection of your health status but a systemic gap in care. Discussing these options with your provider and understanding insurance coverage is essential, as prescription rates remain extremely low despite high eligibility.

Nine weeks of set-volume equated hip thrust training produces gluteus maximus hypertrophy equivalent to back squat training, despite higher acute gluteal muscle activation during hip thrusts.

If your goal is glute growth, you can use either hip thrusts or back squats. They produce similar muscle growth when you do the same number of sets and reps. Don't feel pressured to only do hip thrusts just because they 'feel' like more glute work; squats are equally effective for building the glutes over time.

Hip thrust training transfers to deadlift strength gains similarly to back squat training.

If you are trying to get stronger at the deadlift, doing hip thrusts will help just as much as doing squats. You don't need to do deadlifts exclusively to improve your deadlift.

In patients with type 2 diabetes, initiating GLP-1 receptor agonists (GLP-1RA) is associated with a significantly higher risk of gastroparesis compared to initiating SGLT2 inhibitors or insulin glargine, while insulin glargine is associated with a higher risk of all-cause mortality compared to GLP-1RA.

If you have type 2 diabetes and are considering a GLP-1RA (like semaglutide or dulaglutide), be aware that these drugs can slow down your stomach emptying, increasing the risk of gastroparesis. This risk is higher with GLP-1RA than with SGLT2 inhibitors (like empagliflozin) or insulin glargine. However, GLP-1RA is associated with a lower risk of death compared to insulin. If you are already at risk for gastroparesis, talk to your doctor about SGLT2 inhibitors as a first-line alternative to GLP-1RA.

Emerging pharmacotherapies, specifically GLP-1 receptor agonists and multi-agonists, induce 15-25% weight loss, challenging the necessity of bariatric surgery for patients with BMI 30-40 kg/m2.

If you have obesity (BMI 30-40) and are considering surgery, discuss GLP-1 based medications (like semaglutide or tirzepatide) with your doctor. These drugs can produce 15-25% weight loss, which is comparable to surgery, offering a non-surgical option with significant metabolic benefits.

Current bariatric surgery guidelines (BMI >= 35, or 30-34.9 with comorbidities) may need re-evaluation due to the efficacy of pharmacotherapy.

If your BMI is between 30 and 40, you may not need surgery. Ask your doctor about GLP-1 medications, which are now effective enough to potentially replace surgery for many patients.

Women experience a significantly lower efficacy-to-tolerability ratio than men when treated with GLP-1 receptor agonists, characterized by disproportionately higher rates of persistent nausea and vomiting relative to weight loss.

If you are a woman taking a GLP-1 medication like semaglutide or tirzepatide, you are statistically more likely to experience nausea and vomiting than a man taking the same drug, even if you lose more weight. This is not a failure of willpower but a biological difference in how your body processes the drug, likely driven by estrogen levels. Discussing this with your provider may lead to strategies like slower dose escalation or phase-specific dosing to manage side effects.

Once-weekly insulin icodec provides glycemic control similar to once-daily insulin glargine with comparable hypoglycemia rates, potentially improving patient acceptability through reduced injection frequency.

If daily injections are burdensome, ask your doctor about once-weekly insulin icodec. It works as well as daily insulin for blood sugar control and has similar side effects, but offers the convenience of fewer injections.

Women with severe obesity and PCOS exhibit significantly higher baseline cognitive restraint eating compared to women with severe obesity without PCOS, yet fail to show favorable alterations in eating behaviors (reduced emotional/uncontrolled eating, increased cognitive restraint) after a 12-month structured weight loss intervention, unlike their non-PCOS counterparts.

If you have PCOS and severe obesity, you can lose significant weight (12-14 kg) with a structured intervention, just like women without PCOS. However, standard dietary restriction alone may not change your eating habits (emotional or uncontrolled eating) as effectively. You likely need targeted behavioral support to address emotional eating, not just calorie counting, to maintain the weight loss.

Type 2 Diabetes Mellitus (T2DM) incidence in the United States increased nearly twenty-fold (from 3.52 to 59.30 per 1,000) between 1990 and 2024, driven by environmental and behavioral risk factors such as obesity and sedentary lifestyles.

The risk of developing Type 2 Diabetes in the US has skyrocketed over the last 30 years, largely due to lifestyle factors like obesity and inactivity, not just better testing. To mitigate this personal risk, focus on modifiable lifestyle factors (diet, activity) rather than assuming healthcare improvements have solved the underlying environmental drivers of the disease.

Native Hawaiian/Pacific Islander populations in the US face the highest diabetes burden, with incidence rates of 94.75 per 1,000 and prevalence of 20.65% in 2020-2024, significantly exceeding other racial/ethnic groups.

If you are Native Hawaiian or Pacific Islander, your statistical risk for diabetes is among the highest in the US. This is not just bad luck; it is influenced by systemic access issues. Prioritize early screening and culturally competent care that addresses both biological risks and social barriers to healthy living.

Brief GP-delivered weight loss advice (approx. 86 seconds) results in a statistically significant mean weight loss of 1.04 kg at 12 months compared to a baseline population average of ~300g, demonstrating that the intervention itself, rather than specific behavioral change techniques (BCTs), drives the outcome.

As a primary care clinician, you do not need extensive training or long consultations to help patients with obesity lose weight. Simply delivering a brief, opportunistic piece of advice (around 1.5 minutes) at the end of a routine visit is sufficient to motivate patients to take action and achieve a modest but significant weight loss (approx. 1 kg) over a year. Focus on the act of advising rather than perfecting specific behavioral techniques.

The use of the Behavioral Change Technique 'Feedback on outcomes of behaviour (future)' significantly increases the likelihood of patients taking action to lose weight by 12 months (OR=6.10), although it does not directly correlate with greater mean weight loss.

When giving brief weight loss advice, explicitly schedule a follow-up appointment or promise to provide feedback on the patient's weight in the future. This specific technique ('Feedback on outcomes of behaviour (future)') makes patients significantly more likely to take action (e.g., diet/exercise changes) within a year, even if the total weight loss isn't drastically different from other methods.

Dietary restriction (including caloric restriction, intermittent fasting, and ketogenic diets) extends healthspan and lifespan by promoting the clearance of senescent cells (senolysis), metabolic reprogramming, and epigenetic rejuvenation.

To leverage dietary restriction for longevity, you can adopt strategies like caloric restriction (eating less without being malnourished), intermittent fasting (eating within specific windows like 16:8), or ketogenic diets (high fat, low carb). These regimens aim to trigger biological processes like clearing out old cells (senolysis) and improving metabolic health, which may extend your healthspan. Start with small changes, like a shorter eating window, and ensure your diet remains nutrient-dense.

Performing leg press exercises with a knee flexion range of motion of approximately 100 degrees yields quadriceps femoris muscle hypertrophy equivalent to performing the exercise with maximum individualized knee flexion (peak ROM) in resistance-trained individuals.

If you are an experienced lifter, you do not need to force your leg press to the absolute bottom if it causes pain or technical breakdown. Stopping at approximately 100 degrees of knee flexion (where your shins are roughly perpendicular to the floor or slightly past) will build your quads just as effectively as going as deep as physically possible. Focus on reaching failure with good form at this depth rather than chasing extreme depth.

Animal protein intake may have a mild protective association with cancer mortality, but plant protein intake is not associated with cancer mortality risk.

While animal protein may have a mild protective association with cancer mortality, plant protein does not show this specific benefit in this study. You do not need to avoid animal protein for cancer prevention, and plant protein is not uniquely protective.

Psychosocial factors (confidence, social support, emotional eating) and metabolic status are stronger predictors of weight loss success in behavioral obesity treatment than diet type (low-fat vs. low-carb) or demographic variables alone.

If you are starting a weight loss program, your success is less about whether you choose low-fat or low-carb and more about your mindset and environment. Assess your confidence in sticking to the plan, manage emotional eating, and ensure your social circle is supportive. If you struggle with emotional eating, seek specific psychological support alongside dietary changes.

Changes in soluble LDL receptor (sLDLR) levels are strongly associated with changes in atherogenic lipoprotein phenotype (ALP) markers, including triglycerides, VLDL, and small LDL particles, independent of diet type (low-carbohydrate vs. low-fat) and BMI change.

This research highlights that soluble LDL receptor (sLDLR) levels track closely with atherogenic lipid profiles (high triglycerides, small LDL) during weight loss, regardless of whether you choose a low-carb or low-fat diet. While sLDLR itself is not a standard clinical target, its association with these markers suggests that individuals with high sLDLR may have a specific metabolic phenotype (atherogenic dyslipidemia) that requires careful monitoring of lipid health during weight loss interventions.

Tirzepatide treatment significantly reduces food cravings and preferences for energy-dense foods (high fat, high sugar, fast food fats) in people with obesity, independent of caloric restriction.

If you struggle with intense cravings for high-fat or high-sugar foods, tirzepatide can help reduce these urges. This isn't just about willpower; the medication physiologically lowers the 'pull' of these foods, making it easier to stick to a healthy diet.

Tirzepatide specifically reduces cravings for fast-food fats (e.g., pizza, hamburgers) more than other high-fat foods (e.g., sausage, fried fish).

Tirzepatide may be particularly effective at reducing cravings for specific fast-food items like pizza and burgers compared to other high-fat foods.

GLP-1 receptor agonist (GLP-1RA) treatment in obese individuals causes a modest absolute decrease in skeletal muscle mass, but preserves or improves relative muscle mass and strength, resulting in maintained or enhanced physical performance.

If you are taking GLP-1 medications for weight loss, expect a small, normal amount of muscle loss alongside your fat loss. This is not pathological wasting; your muscles are actually working better relative to your new body weight. Focus on maintaining strength through activity, as your mobility and endurance may actually improve.

Fixed-ratio combinations (FRCs) of basal insulin and GLP-1 receptor agonists are indicated for patients with type 2 diabetes who are inadequately controlled on oral antihyperglycemic drugs (OADs) with an HbA1c less than 10% and within 2% of their glycemic goal, or for those already on basal insulin who remain above goal.

If you are taking oral diabetes medications but your blood sugar is still too high (HbA1c less than 10% and within 2% of your target), or if you are already on basal insulin but your levels are still above goal, ask your doctor about a fixed-ratio combination (FRC). These are single injections that combine a long-acting insulin with a GLP-1 medication. They are designed to lower blood sugar effectively, minimize weight gain, and reduce the number of injections you need to manage compared to traditional basal-bolus therapy.

For patients with Type 2 Diabetes requiring basal insulin, a glycated hemoglobin (HbA1c) goal of less than 7% is appropriate, whereas a goal of less than 6.5% is less likely to be appropriate due to increased risks of hypoglycemia and weight gain.

If you are on basal insulin, aim for an HbA1c of less than 7%. Trying to get it below 6.5% when you are on insulin can increase your risk of dangerous low blood sugar and weight gain without providing significant additional long-term benefits. Your doctor should adjust your goal based on your specific health situation, but <7% is generally the safe target for insulin users.