Browse the evidence

Long-acting GLP-1 receptor agonists provide superior glycemic control (HbA1c) compared to short-acting GLP-1 receptor agonists, though short-acting agents may offer greater weight loss benefits.

If your main goal is lowering your average blood sugar (HbA1c), choose a long-acting GLP-1 agonist (like dulaglutide or liraglutide). If weight loss is your primary driver, short-acting options (like exenatide) might offer a slight edge, though long-acting agents are still effective for weight.

Discontinuation of second-generation anti-obesity medications (semaglutide and tirzepatide) leads to rapid and substantial weight regain, often returning to baseline cardiometabolic status, demonstrating the chronic nature of obesity and the need for indefinite treatment.

If you stop taking semaglutide or tirzepatide, you will likely regain most of the weight you lost within a year. This demonstrates that obesity is a chronic condition requiring long-term treatment, similar to high blood pressure. To maintain weight loss, you likely need to continue the medication indefinitely.

Prospective observational cohort studies provide evidence on chronic disease outcomes that is generally concordant with randomized controlled trials, despite limitations in blinding and compliance inherent in lifestyle trials.

Trust long-term dietary patterns observed in large populations, not just short-term experiments. The science supports that what people actually eat over time correlates with health outcomes just as well as controlled trials.

Intensive lifestyle interventions in obese individuals with type 2 diabetes produce significant fat mass loss, but this benefit is eroded over 8 years by substantial lean mass loss and fat mass regain, resulting in convergence with non-intervention groups.

If you have type 2 diabetes and are overweight, an intensive lifestyle program can help you lose fat, but be prepared for a long-term challenge. You will likely lose some muscle along with fat, and maintaining the weight loss requires continuous effort. Don't expect the results to stay perfect forever; focus on keeping fat mass down as much as possible, as this reduces long-term health risks.

Sustained moderate caloric restriction (average 11.9% reduction over 24 months) improves aging-related biomarkers and metabolic health without causing adverse psychological or behavioral outcomes in healthy, non-obese adults.

To improve aging biomarkers and metabolic health, aim for a moderate, sustained reduction in calorie intake (around 10-12%) over a long period (e.g., 2 years). This should be done with professional guidance, using behavioral strategies to maintain adherence, and ensuring you take a multivitamin and calcium supplement to prevent deficiencies. This approach is safe and effective even for non-obese individuals.

Cognitive Behavioral Therapy (CBT) is the current treatment of choice for Binge Eating Disorder and is effective in reducing binge frequency and achieving remission, though it may not significantly reduce weight.

If you have Binge Eating Disorder, Cognitive Behavioral Therapy (CBT) is the most effective treatment available. It typically involves weekly sessions for 12-16 weeks and helps you identify triggers and change thought patterns. While it may not lead to significant weight loss, it is highly effective at stopping binge episodes and achieving remission. If traditional CBT is not accessible, ask about guided self-help options.

SGLT2 inhibitors reduce the risk of heart failure, cardiovascular events, and renal progression in patients with type 2 diabetes, independent of glycemic control.

If you have type 2 diabetes and heart or kidney issues, ask your doctor about SGLT2 inhibitors. They protect your heart and kidneys, not just your blood sugar.

Semaglutide reduces cardiovascular risk (MACE) and non-ASCVD deaths (including from infections) in overweight/obese patients with established cardiovascular disease, independent of diabetes status.

If you are overweight or obese and have heart disease, semaglutide 2.4mg weekly can reduce your risk of heart attack, stroke, and death by 20%, even if you don't have diabetes. It may also reduce death from infections.

Weight loss slows down and eventually plateaus because energy expenditure decreases as body composition shifts (specifically, loss of metabolically expensive lean tissue), creating a new steady state where energy intake equals expenditure.

Expect your weight loss to slow down and stop at a new 'plateau' even if you keep eating the same amount less. This happens because your body burns fewer calories as it gets smaller and loses muscle. To continue losing weight, you must further reduce calories or increase activity to match your new, lower energy expenditure.

Termination of long-term intensive lifestyle intervention (ILI) counseling in adults with type 2 diabetes does not trigger rapid, significant weight regain; instead, participants maintain weight loss for at least 2 years post-termination, with ILI participants retaining significantly greater use of weight-control behaviors than controls.

If you have type 2 diabetes and are overweight, sticking to the healthy habits you learned during a weight loss program (like counting calories, exercising, and weighing yourself) can help you keep the weight off for years, even after you stop seeing a counselor regularly. You don't necessarily need to pay for ongoing sessions to maintain your progress, as long as you keep practicing the behaviors.

Obesity and type 2 diabetes are independent and joint risk factors for the development of multiple types of cancer, with obesity being the second strongest modifiable risk factor after smoking.

Maintaining a healthy weight and managing blood sugar are critical for cancer prevention. Since obesity is the second strongest modifiable risk factor for cancer after smoking, addressing metabolic health through lifestyle changes or medical management can significantly lower your risk of developing multiple types of cancer.

GLP-1 receptor agonists (GLP-1 RAs) reduce major adverse cardiovascular events (MACE) in patients with type 2 diabetes and high cardiovascular risk, primarily by reducing non-fatal myocardial infarction and stroke.

If you have Type 2 Diabetes and are at high risk for heart disease, GLP-1 receptor agonists (like semaglutide or liraglutide) are a primary treatment option that not only lowers blood sugar but significantly reduces the risk of heart attack and stroke. These medications are taken via injection (daily or weekly) and have been shown in large clinical trials to improve cardiovascular outcomes compared to placebo.

Obesity, particularly visceral adipose tissue (VAT) accumulation, promotes cardiovascular disease through mechanisms including chronic inflammation, insulin resistance, and endothelial dysfunction, leading to conditions like hypertension, atherosclerosis, and heart failure.

Obesity is not just about weight; it causes real physical changes in your body, especially around your belly (visceral fat), that increase your risk of heart disease, high blood pressure, and diabetes. These changes involve inflammation and hormonal imbalances that damage your blood vessels and heart. Understanding this helps explain why treating obesity is crucial for long-term heart health, not just appearance.

Total daily energy expenditure (TDEE) in healthy, free-living, non-athlete individuals is primarily composed of resting energy expenditure (approx. 60%), physical activity energy expenditure (approx. 30%), and the thermic effect of food (approx. 10%).

To understand your daily energy needs, recognize that most energy (60%) is used just to keep your body running at rest, about 30% goes to movement, and 10% is used to digest food. This breakdown helps in estimating caloric requirements for health maintenance.

Physical activity energy expenditure (PAEE) is highly variable among individuals and can range from almost none in bedridden individuals to approximately 50% of TDEE in highly active individuals.

Your physical activity level is the most variable component of your daily energy expenditure. Increasing your movement can significantly increase your total energy needs.

SGLT2 inhibitors and GLP-1 agonists provide significant cardiovascular and renal protection in Type 2 Diabetes, independent of their glucose-lowering effects.

If you have Type 2 Diabetes and are at risk for heart or kidney problems, ask your doctor about SGLT2 inhibitors or GLP-1 agonists. These medications have been shown to protect your heart and kidneys, offering benefits beyond just lowering blood sugar.

Females achieve similar relative increases in muscle mass and strength compared to males following resistance exercise training, despite having significantly lower systemic testosterone concentrations.

Women should not fear that resistance training will make them 'too bulky' compared to men. Your body responds to resistance training with similar relative gains in muscle size and strength as men, despite having lower testosterone. Focus on progressive overload just as you would for a male partner.

GLP-1 receptor agonists and endogenous GLP-1 provide cardiovascular protection by improving endothelial function, reducing blood pressure, and protecting the myocardium.

For individuals with Type 2 Diabetes or high cardiovascular risk, GLP-1 receptor agonists (like liraglutide or semaglutide) are not just glucose-lowering drugs but cardioprotective agents. They improve blood vessel function, lower blood pressure, and reduce the risk of major adverse cardiac events (heart attack, stroke, death).

Obesity is associated with significant health consequences including metabolic diseases, fat mass diseases, and increased mortality, driving high healthcare costs.

Obesity is not just a cosmetic issue; it significantly increases the risk of diabetes, heart disease, and other conditions, leading to much higher healthcare costs. Managing weight is a critical component of long-term health and financial well-being.

Statin therapy is the first-line treatment for dyslipidemia in type 2 diabetes, significantly reducing cardiovascular events, although it only modestly lowers triglycerides.

Take your prescribed statin daily. It is the most effective tool for preventing heart attacks and strokes in type 2 diabetes. While it may not lower triglycerides drastically on its own, it is essential for your overall cardiovascular health.

Discontinuation of GLP-1 therapy leads to rapid and substantial weight regain, often returning to near baseline levels within one year, highlighting the chronic nature of obesity treatment.

GLP-1 medications are not a one-time fix for obesity. If you stop taking them, you will likely regain most of the weight you lost. This suggests that obesity management with these drugs is intended to be long-term, similar to managing blood pressure or cholesterol.

Long-acting GLP-1 receptor agonists (e.g., semaglutide 2.4 mg) and multi-agonists (e.g., tirzepatide) produce significant, dose-dependent weight loss (10-21%) in adults with obesity, but discontinuation leads to substantial weight regain, indicating these are chronic management tools rather than cures.

GLP-1 and multi-agonist medications are highly effective for significant weight loss (10-20%+), but they are not cures. You must take them long-term to maintain results. If you stop, your body will likely fight to regain the weight. Expect some stomach issues initially, but these often fade. Work with your doctor to find the right dose.

GLP-1 receptor agonists (specifically liraglutide, semaglutide, and dulaglutide) significantly reduce major adverse cardiovascular events (MACE) in patients with type 2 diabetes and high cardiovascular risk, independent of baseline BMI.

If you have Type 2 Diabetes and high heart risk, GLP-1 medications like liraglutide, semaglutide, or dulaglutide are proven to significantly lower your risk of heart attack, stroke, and heart-related death. These benefits exist even if your weight loss isn't massive. Discuss these options with your doctor, especially if you have existing heart disease.

SGLT2 inhibitors (specifically empagliflozin and canagliflozin) reduce major adverse cardiovascular events (MACE) in patients with Type 2 Diabetes, with empagliflozin also reducing heart failure hospitalizations.

If you have Type 2 Diabetes and heart risk, SGLT2 inhibitors like empagliflozin or canagliflozin can significantly lower your risk of heart attack, stroke, and heart failure hospitalization. These drugs work by removing excess sugar through urine. Discuss these with your doctor, especially if you have heart failure.