Browse the evidence

Multicomponent behavioral interventions, including Cognitive Behavioral Therapy (CBT) and Motivational Interviewing (MI), produce 5-10% weight loss and are essential for addressing psychological barriers and sustaining lifestyle changes.

Engage in structured behavioral programs that include self-monitoring, goal setting, and problem-solving. Cognitive Behavioral Therapy (CBT) is particularly effective for those with binge eating, while Motivational Interviewing (MI) helps resolve ambivalence. These interventions typically yield 5-10% weight loss and are most effective when combined with lifestyle changes and, if necessary, medication.

Combining aerobic and resistance exercise yields the best results for weight loss maintenance and metabolic health, with resistance training independently lowering obesity risk.

Aim for at least 150 minutes of moderate aerobic activity (like brisk walking) per week, plus 2-3 sessions of resistance training focusing on major muscle groups. For better weight loss maintenance, aim for 200-300 minutes of moderate exercise. Tailor the type of exercise to your preferences and physical limitations to ensure sustainability.

Gut hormone-based pharmacotherapies (GLP-1RAs, amylin analogues, and multi-agonists) produce clinically significant weight loss (≥10-15%) and improve cardiometabolic health, effectively closing the treatment gap between lifestyle interventions and bariatric surgery.

For individuals with obesity who have not achieved sufficient weight loss through lifestyle changes alone, gut hormone-based medications (like semaglutide or tirzepatide) offer a clinically effective treatment option that can produce 10-15% or more weight loss. These treatments work by targeting the body's natural appetite-regulating systems, mimicking the effects of bariatric surgery to a degree, and improving metabolic health. While side effects like nausea are common, they often subside with dose titration, and new oral formulations are emerging to address injection aversion.

Combination therapies targeting multiple gut hormone pathways (e.g., GLP-1 + Amylin, GLP-1 + GIP, GLP-1 + GIP + Glucagon) show superior weight loss efficacy compared to monotherapies, approaching the magnitude of weight loss seen after bariatric surgery.

For patients who do not achieve sufficient weight loss with single-agent GLP-1 therapy, combination treatments (like CagriSema or Tirzepatide) offer a powerful alternative. These drugs target multiple hormonal pathways simultaneously, resulting in greater weight loss (up to 17% or more in trials) than monotherapies alone. This approach narrows the gap between medication and surgery, offering a viable option for those with severe obesity.

Tirzepatide, a GLP1:GIP dual agonist, provides superior glycemic and weight-loss efficacy compared to placebo, achieving >20% body weight loss in 57% of participants at the highest dose over 72 weeks.

Tirzepatide, a dual GLP1:GIP agonist, has demonstrated superior efficacy in Phase 3 trials, achieving over 20% body weight loss in more than half of participants at the highest dose over 72 weeks with minimal side effects. This makes it a highly effective option for managing diabesity compared to placebo.

Higher protein intake (≥25% TDE or ≥1.25 g/kg/day) during energy restriction promotes greater fat loss and fat-free mass preservation compared to standard protein intakes, with modest but clinically relevant long-term weight maintenance benefits.

To maximize fat loss and preserve muscle while dieting, aim for at least 1.25 grams of protein per kilogram of body weight daily, or roughly 25% of your total calories from protein. This approach helps you feel fuller longer and burns slightly more calories through digestion, leading to better fat loss and muscle retention than standard protein intakes.

Moderate-to-high intensity aerobic exercise (150-420 min/week) produces dose-dependent weight loss (2-7.5 kg), and 200-300 min/week is recommended for weight maintenance, largely by preserving fat-free mass and energy expenditure.

To lose 2-7.5 kg, aim for 150-420 minutes of moderate-intensity aerobic exercise per week. For maintaining weight loss, target 200-300 minutes per week. This helps preserve muscle and energy expenditure, making long-term success more likely.

Combined aerobic and resistance exercise provides superior glycemic control in type 2 diabetes compared to either modality alone.

For best blood sugar control, mix your cardio with strength training. You don't need to do them separately; combining both types of movement is more effective for managing glucose than doing just one.

High-Intensity Interval Training (HIIT) achieves similar or superior glycemic and fitness benefits to endurance training in a shorter duration, making it a time-efficient option for T2D management.

If you are short on time, try High-Intensity Interval Training (HIIT). It can improve your blood sugar and fitness as well as or better than long, steady workouts, but in less time.

Aerobic exercise is more effective than resistance training alone for reducing body mass and fat mass in sedentary, overweight individuals.

If your primary goal is fat loss, prioritize aerobic exercise over resistance training alone. However, include resistance training to preserve or build lean muscle mass, as it offers distinct benefits for body composition despite being less effective for fat loss alone.

Daily exercise training (morning or evening) reduces fasting concentrations of large LDL particles (LDL-1) and small HDL particles (HDL-3/4) in men with overweight/obesity, independent of time-of-day.

If you are overweight or obese, engaging in daily exercise (combining high-intensity intervals and moderate cycling) for just 5 days can significantly improve your LDL and HDL particle profiles, regardless of whether you exercise in the morning or evening. Focus on consistency and intensity rather than the specific time of day.

Consulting with a sports Registered Dietitian (RD) regarding supplement choices is associated with a lower risk of using non-third-party tested supplements.

Talking to a sports dietitian about your supplements significantly lowers your risk of using contaminated products. If you can't see one, ensure you search for information yourself and look for third-party testing logos.

Triple agonist Retatrutide (12 mg/week for 48 weeks) and dual agonist Tirzepatide (15 mg/week for 72 weeks) produce superior weight loss (24.2% and 20.9% respectively) in adults with obesity compared to traditional anti-obesity medications, with even greater effects in those with BMI ≥ 35 kg/m².

Newer drugs like Retratrutide (triple agonist) and Tirzepatide (dual agonist) offer significantly higher weight loss (20-26%) than older drugs. Retratrutide 12mg weekly for 48 weeks and Tirzepatide 15mg weekly for 72 weeks are key examples. These are more effective than traditional options, especially for those with BMI ≥ 35, but cost is a major barrier.

GLP-1 receptor agonists (GLP-1RAs) and sodium-glucose co-transporter-2 inhibitors (SGLT2-is) significantly improve hepatic steatosis and steatohepatitis in patients with MASLD, primarily through weight loss and glycemic control, with some agents also demonstrating antifibrotic properties.

If you have fatty liver disease (MASLD), especially if you also have type 2 diabetes or obesity, GLP-1 receptor agonists (like semaglutide or liraglutide) and SGLT2 inhibitors (like empagliflozin or dapagliflozin) are currently the most effective and accessible pharmaceutical options. They work by improving insulin sensitivity, promoting weight loss, and directly reducing liver fat and inflammation. While they may require injections (for GLP-1RAs) and can cause mild stomach upset, their benefits for both liver and heart health make them a cornerstone of treatment. Always consult your doctor to determine the best option for your specific health profile.

Bariatric surgery, particularly laparoscopic sleeve gastrectomy, provides durable weight loss and improves obesity-related conditions like type 2 diabetes and cardiovascular disease, making it an effective and durable treatment for obesity.

Bariatric surgery, especially sleeve gastrectomy, is a proven, durable treatment for obesity that significantly improves conditions like type 2 diabetes and heart disease. If you are considering surgery, discuss the benefits and risks with a healthcare provider, and explore both public and private options to find the best fit for your financial and medical situation.

Resistance exercise is the most effective lifestyle intervention for increasing muscle strength in people with type 2 diabetes (T2D), although it may induce an anabolic resistance regarding muscle mass gains compared to healthy controls.

For people with Type 2 Diabetes, resistance training is the best way to build strength. While it might not build as much muscle mass as it does in healthy people (due to 'anabolic resistance'), it is still superior to aerobic exercise for strength. Aim for at least two days a week of resistance training, potentially starting with home-based programs if gym access is a barrier.

Pharmacotherapies for T2D and obesity, specifically GLP-1 receptor agonists (e.g., Tirzepatide) and SGLT2 inhibitors, cause significant loss of lean body mass (20-50% of total weight loss), necessitating concurrent resistance exercise and protein intake to mitigate muscle loss.

If you are taking GLP-1 or SGLT2 medications for diabetes or weight loss, expect to lose some muscle along with fat (up to 50% of the weight). To protect your metabolism and strength, you must combine these medications with resistance exercise and adequate protein intake, as the drugs themselves do not preserve muscle.

Unimolecular GLP1R/GIPR dual agonists (e.g., tirzepatide) produce superior body weight reduction and glycemic improvements compared to GLP-1 receptor agonists alone, driven by GIP receptor signaling in central nervous system GABAergic neurons.

If you are managing obesity or Type 2 Diabetes, dual-acting medications (like tirzepatide) that target both GLP-1 and GIP receptors have shown superior weight loss (up to 20-22%) compared to GLP-1 only drugs. These are taken once weekly. Discuss with your doctor if this option is suitable, noting it may help mitigate some nausea associated with GLP-1 only treatments.

Tirzepatide (5, 10, and 15 mg) achieves stringent glycemic (HbA1c < 5.7% or ≤ 6.5%) and weight loss (≥ 10% or ≥ 15%) targets with a statistically significantly lower cost per responder and lower number needed to treat (NNT) compared to semaglutide 1 mg in patients with type 2 diabetes.

If you have Type 2 Diabetes and are struggling to reach strict blood sugar (HbA1c < 5.7% or ≤ 6.5%) or significant weight loss goals (≥ 10-15%) with metformin, switching to or starting tirzepatide (5-15 mg weekly) is likely more effective and cost-efficient for achieving those specific targets than using semaglutide 1 mg. While tirzepatide has a higher yearly drug price, you are more likely to succeed with it, making it 'cheaper' per successful outcome.

Semaglutide demonstrates superior weight loss and glycemic control compared to other GLP-1RAs like liraglutide and dulaglutide, with weight loss ranging from 10% to over 20%.

Semaglutide (Wegovy) is a once-weekly injection that has shown significant weight loss (10-20%) in clinical trials, outperforming other drugs in its class. It is approved for chronic weight management in adults and adolescents. You must combine it with diet and exercise. Be aware that it is expensive and may face supply shortages due to high demand.

Tirzepatide, a dual GIP and GLP-1 receptor agonist, provides superior weight loss and metabolic improvements compared to selective GLP-1RAs, insulin, and placebo.

Tirzepatide is a once-weekly injection that targets two hormones (GIP and GLP-1) to improve blood sugar and promote weight loss. Clinical trials show weight loss of 15-21% depending on the dose. It is approved for Type 2 Diabetes and is being studied for obesity. It is more effective than some other GLP-1 drugs and insulin in terms of weight loss and metabolic markers.

Tirzepatide, a dual GIP and GLP-1 receptor agonist, provides superior glycemic control and weight reduction compared to semaglutide and insulin in patients with type 2 diabetes.

For patients with type 2 diabetes, especially those with cardiovascular risks or obesity, tirzepatide offers a powerful once-weekly treatment option. It significantly lowers blood sugar and promotes substantial weight loss, often outperforming other common medications like semaglutide or insulin. While cost and injection concerns exist, the clinical benefits for glycemic control and weight management are substantial.

Performing resistance training sets to concentric failure is necessary to optimize strength and muscle mass gains when using low loads (30-50% 1RM), whereas it is not necessary and potentially counterproductive when using high loads (>70% 1RM).

If you are training at home with light weights or bands, push your sets until you can no longer complete a repetition with good form (concentric failure) to ensure you get strength and muscle benefits. If you have heavier weights, you do not need to go to failure on every set; stopping a few reps short may allow you to do more total work and recover better.

High training frequency (>5 days/week) is recommended to mitigate detraining effects during periods of social distancing and limited training access.

Try to move your body and perform some form of resistance exercise on most days of the week (more than 5 times). You don't need long sessions; integrating movement into daily life and doing shorter workouts frequently helps prevent loss of fitness.