Browse the evidence

Liraglutide (3 mg once daily) produces a mean weight loss of 8% over 56 weeks in patients without diabetes.

If you are prescribed Liraglutide (Saxenda), expect to take a 3 mg injection once daily. This can lead to an 8% reduction in body weight over 56 weeks. Be prepared for potential gastrointestinal side effects like nausea, which can often be managed by eating smaller meals.

Subcutaneous semaglutide (up to 1.0 mg once-weekly) produces significantly greater reductions in BMI and waist circumference compared to liraglutide (up to 3.0 mg once-daily) in obese patients with type 2 diabetes over a 12-month period, while both agents significantly lower HbA1c.

For obese patients with type 2 diabetes, switching from or choosing semaglutide over liraglutide is likely to result in greater weight loss and waist circumference reduction. While both drugs effectively lower blood sugar, semaglutide offers superior body composition benefits. Patients should be aware that gastrointestinal side effects are common, especially with semaglutide, but these often subside as the dose is titrated up.

Weight loss exceeding 10% of body weight significantly reduces liver fibrosis in patients with non-alcoholic fatty liver disease (NAFLD).

To reverse liver scarring (fibrosis), you need to lose more than 10% of your total body weight. Losing 5-7% helps with liver fat, but hitting that 10% threshold is the key to fixing the scar tissue. This is the most effective treatment currently available.

Obesity pharmacotherapy (GLP-1/GIP agonists) reduces body weight with minimal loss of lean mass and improves cardiovascular outcomes, potentially mitigating the adverse effects of intermittent fasting.

If you are considering obesity pharmacotherapy (like GLP-1 agonists), know that it can lead to significant weight loss (up to 21% in some trials) with minimal loss of muscle mass, which is a key advantage over intermittent fasting. It also reduces cardiovascular risk. However, long-term safety is still being studied, and combining it with lifestyle changes (diet and exercise) is recommended for the best outcomes.

Performing past-failure partial repetitions in the lengthened position after reaching momentary failure during standing calf raises increases medial gastrocnemius hypertrophy compared to terminating sets at momentary failure in peak plantarflexion.

If you do calf raises, don't stop when you can no longer lift your heels all the way up. Once you fail a full repetition, immediately drop the heel as low as possible and do partial up-and-down movements until you can't lift your heels to that lowest point anymore. This adds significant volume and tension to the muscle, leading to more growth than stopping at the point of failure. Expect it to be uncomfortable, but for many, the extra growth is worth it.

Resistance training improves handgrip strength in older adults with sarcopenia, with an optimal dose of 3 sessions/week at 49% 1RM, 19 weeks duration, 15 exercises, 16 reps, 6 sets, totaling 1,400 reps/week.

If you are an older adult with sarcopenia, aim for 3 resistance training sessions per week. Use a weight that feels like 49% of your maximum lift (moderate effort). Perform 15 different exercises, doing 6 sets of 16 repetitions for each. Keep your total weekly repetitions around 1,400. Stick to this plan for 19 weeks to see the best improvement in your handgrip strength.

Fasting interventions significantly reduce liver health biomarkers (ALT and liver stiffness) in individuals with MASLD compared to control diets.

For those with MASLD, structured fasting approaches (like Alternate Day Fasting, 5:2 diets, or Time-Restricted Eating) have been shown in meta-analyses to significantly lower liver enzymes (ALT) and reduce liver stiffness compared to control diets. These benefits are linked to improvements in insulin resistance and triglyceride levels. Most effective studies lasted 3 months, so long-term sustainability needs more research, but the short-term liver health gains are robust.

The Mediterranean Diet (MedDiet) significantly improves liver health biomarkers (ALT, liver stiffness, and MRI-PDFF) in individuals with MASLD.

Adhering to a Mediterranean Diet significantly improves liver health in people with MASLD, lowering liver enzymes, reducing liver stiffness, and decreasing liver fat content. Studies lasted from 3 to 24 months, showing consistent benefits. This dietary pattern is a strong, evidence-based first-line approach for managing liver health.

A primary care-led, very-low-calorie diet (825-853 kcal/day) can induce remission of type 2 diabetes, with remission rates directly correlating to the magnitude of weight loss (86% remission with >15% weight loss).

If you have early-stage type 2 diabetes, talk to your doctor about a medically supervised very low-calorie diet (around 800-850 calories/day). The goal is to lose at least 15kg (33lbs) if you weigh 100kg, or roughly 15% of your body weight. This specific level of weight loss has been shown to put diabetes into remission in the majority of cases by reducing fat in the liver and pancreas.

GLP-1 receptor agonists (e.g., Liraglutide, Semaglutide) and dual/triple agonists are highly effective for weight loss and diabetes remission, acting on both homeostatic and hedonic appetite pathways, but require continuous use to maintain effects.

GLP-1 medications (like Semaglutide or Liraglutide) are highly effective for significant weight loss and diabetes remission, often working better than diet alone. They work by reducing both physical hunger and the 'craving' for food. However, they must be taken continuously; stopping them usually leads to weight regain. Discuss with your doctor if you are a candidate, considering the cost and injection requirement.

High dietary fiber intake (specifically viscous fibers like beta-glucan) reduces coronary risk, primarily through cholesterol reduction, and specific functional claims (e.g., 3g/day beta-glucan) are recognized by regulatory bodies.

Eat more fiber-rich foods like oats, barley, fruits, and vegetables. Aim to increase your intake by 10g per day to significantly lower coronary risk. If using fiber supplements like beta-glucan, 3g per day is effective for cholesterol. Take medications at least an hour before or two hours after fiber supplements to avoid absorption issues.

Consuming ≥2 servings/week of sugar-sweetened beverages (SSBs) or artificially sweetened beverages (ASBs) is associated with a significantly higher risk of type 2 diabetes, even among adults who meet physical activity guidelines.

If you drink sugary or artificially sweetened beverages frequently (≥2 servings/week), your risk of type 2 diabetes increases, even if you exercise regularly. While exercise helps mitigate this risk, it does not cancel it out. To lower your diabetes risk, you should reduce your intake of these beverages in addition to staying active.

Dual GLP-1/GIP receptor agonists (e.g., tirzepatide) achieve weight loss magnitudes (15-20%) comparable to bariatric surgery, significantly outperforming older pharmacotherapies and single-agonist GLP-1s.

If you have obesity, newer dual-agonist medications (like tirzepatide) are currently the most effective non-surgical treatment available, offering weight loss results similar to bariatric surgery. They work by targeting multiple hormonal pathways to reduce appetite and improve metabolism. Consult a doctor to see if you qualify based on your BMI and comorbidities.

Early response to treatment (≥5% weight loss in 3 months) is a strong predictor of long-term success; non-responders should switch therapies.

Monitor your weight closely in the first 3 months of starting a new obesity medication. If you haven't lost at least 5% of your body weight, talk to your doctor about switching to a different therapy. Early success is the best predictor of long-term success.

Endoscopic Sleeve Gastroplasty (ESG) using full-thickness suturing produces durable weight loss (mean 64-67% Excess Weight Loss at 12 months) and significant improvement/remission of metabolic comorbidities (T2DM, hypertension, NAFLD) in patients with BMI 30-50 kg/m2, outperforming lifestyle modifications and intragastric balloons.

ESG is a minimally invasive endoscopic procedure that reduces stomach volume and delays emptying to promote satiety. It is suitable for adults with BMI 30-50 who want a durable alternative to lifestyle changes or balloons, with high success rates for weight loss and metabolic improvement. It requires general anesthesia and has a low risk of serious complications.

Retatrutide, a triple agonist of GLP-1, GIP, and glucagon receptors, produces significant, dose-dependent reductions in body weight, BMI, and metabolic markers in obese adults with or without type 2 diabetes.

Retatrutide is a weekly injection that significantly reduces body weight (average ~14%) and improves metabolic health in obese adults, including those with type 2 diabetes. It works by targeting three hormone receptors (GLP-1, GIP, glucagon) to reduce appetite and improve insulin sensitivity. Higher doses (8-12 mg) generally produce greater weight loss. Common side effects include nausea and vomiting, which are often manageable. It is a prescription medication requiring medical supervision.

Combining bimagrumab (30 mg/kg IV every 12 weeks) with semaglutide (2.4 mg SC weekly) produces synergistic weight loss and body recomposition, achieving significantly greater fat mass reduction and lean mass preservation than either drug alone.

If you have obesity, combining a muscle-preserving antibody (bimagrumab) with a standard GLP-1 drug (semaglutide) yields significantly more fat loss and better muscle retention than using semaglutide alone. This suggests that targeting muscle preservation directly can enhance the efficacy of standard weight loss therapies.

In real-world clinical practice, tirzepatide produces significantly greater weight loss and higher rates of achieving 5%, 10%, and 15% weight reduction thresholds compared to semaglutide in adults with overweight or obesity.

If you are choosing between semaglutide and tirzepatide for weight loss, real-world data suggests tirzepatide is likely to produce roughly double the weight loss at one year compared to semaglutide. You are also significantly more likely to hit major weight loss milestones (5%, 10%, 15%) with tirzepatide. However, this comes with the caveat that these specific findings are based on formulations labeled for Type 2 Diabetes, and insurance coverage may be more difficult to obtain for tirzepatide than semaglutide.

A healthy low-carbohydrate diet (HLCD) combined with caloric restriction produces greater fat mass loss than caloric restriction alone in adults with overweight or obesity.

To lose fat effectively, try a healthy low-carb diet that cuts calories by about 25%. Focus on getting 30% of your calories from carbs (like whole grains and veggies), 50% from healthy fats (like nuts, oils, and avocados), and 20% from plant proteins. This approach helps you lose more fat than just eating less without changing what you eat.

Low-carbohydrate diets (LCDs) are superior to low-fat diets (LFDs) for improving glycemic control (HbA1c) and reducing body weight in Type 2 Diabetes Mellitus (T2DM) patients, with benefits persisting for up to 1.5 years for HbA1c and 2 years for HDL-C, though weight loss benefits diminish after 2 years.

If you have Type 2 Diabetes, switching to a low-carbohydrate diet (less than 130g carbs per day) is likely to lower your blood sugar (HbA1c) and help you lose more weight than a standard low-fat diet. These benefits for blood sugar and good cholesterol (HDL) can last for 1.5 to 2 years. However, be aware that the extra weight loss you get from cutting carbs tends to fade after 2 years, so long-term adherence is key. Contrary to common fears, this approach did not show worse heart or kidney markers compared to low-fat diets in this review.

Very-Low-Carbohydrate Diets (VLCDs, <10% energy or 20-50g carbs) produce significantly greater weight loss than standard Low-Carbohydrate Diets (LCDs) or Low-Fat Diets (LFDs) in T2DM patients.

If you are willing to restrict carbohydrates to 20-50 grams per day (less than 10% of your calories), you can expect significantly more weight loss (nearly 9.5 kg more than low-fat diets) than with standard low-carb or low-fat approaches. This is the most effective dietary strategy for weight loss in T2DM patients identified in this review, though maintaining such strict limits long-term is challenging.

Low-carbohydrate diets improve cardiovascular risk factors (Triglycerides and HDL-C) compared to low-fat diets in T2DM patients, with benefits for HDL-C persisting up to 2 years.

Switching to a low-carb diet helps improve your blood fats. It lowers Triglycerides and raises HDL (good) cholesterol more effectively than a low-fat diet. These heart-healthy changes can last for up to 2 years. Importantly, this improvement happens without negatively affecting your LDL (bad) cholesterol or blood pressure compared to low-fat diets.

A 12-month behavioral weight-loss intervention combining energy-restricted diets (20% or 35% fat) with nutrition education and exercise produces sustained weight loss and improved cardiometabolic markers, regardless of whether the diet is lower-fat or moderate-fat.

To lose weight sustainably, focus on creating a caloric deficit through a balanced, nutrient-dense diet and regular exercise, rather than obsessing over specific fat percentages. Whether you choose a lower-fat or moderate-fat diet, the key is adherence to behavioral changes, improved diet quality, and consistent physical activity. Aim for a 500-1000 calorie daily deficit initially, then transition to maintenance calories while keeping diet quality high.

Higher diet quality, as measured by the Healthy Eating Index (HEI), is associated with greater weight loss in the early stages (4 months) of a weight-loss intervention, regardless of macronutrient distribution.

Focus on improving your overall diet quality by eating more fruits, vegetables, whole grains, and lean proteins. This approach is linked to better weight loss outcomes, especially in the first few months of a diet, regardless of whether you choose a low-fat or moderate-fat diet.