Browse the evidence

A comprehensive behavioral intervention including nutrition education and exercise improves cardiometabolic risk factors (total cholesterol, LDL, HDL, triglycerides, CRP, systolic blood pressure) and body composition (lean mass, body fat, VO2max) over 12 months, regardless of whether the diet is lower-fat or moderate-fat.

Improving your diet and exercise habits not only helps with weight loss but also significantly improves your cholesterol, blood pressure, and overall heart health. These benefits are achieved regardless of whether you choose a lower-fat or moderate-fat diet, as long as you maintain a healthy lifestyle.

Sustained, non-surgical, non-pharmacological weight loss from overweight (BMI ≥25) to healthy weight (BMI <25) during midlife (ages 40-50) is associated with a significantly decreased risk of incident chronic diseases (excluding type 2 diabetes) and all-cause mortality compared to persistent overweight.

If you are in midlife (40s-50s) and currently overweight, achieving and maintaining a healthy BMI (under 25) through lifestyle changes (diet and exercise) significantly lowers your risk of developing chronic diseases and dying prematurely compared to staying overweight. This benefit is independent of diabetes risk and does not require surgery or medication. The key is sustainability; the health benefits accrue over decades.

Adhering to the MyPlate dietary pattern (focusing on fruits, vegetables, whole grains, and protein) reduces central adiposity (waist circumference) in overweight, low-income patients, offering a practical alternative to calorie counting.

Follow the MyPlate guidelines: fill half your plate with fruits and vegetables, one-quarter with whole grains, and one-quarter with quality protein. You do not need to count calories. This approach helps reduce belly fat (waist circumference) and is easier to stick to long-term than strict calorie counting, especially if you find tracking numbers stressful.

Weekly subcutaneous VK2735, a GIP/GLP-1 receptor dual agonist, produces significant, dose-dependent weight loss in adults with obesity or overweight (≥1 comorbidity) over 13 weeks, with the 15 mg dose achieving a mean 14.7% reduction.

Take VK2735 once weekly as prescribed. Start with the lowest dose (2.5 mg) and follow the titration schedule to minimize side effects. Combine with a 500 kcal daily caloric deficit and 150 minutes of exercise per week for best results. Expect significant weight loss (up to 14.7% at 15 mg) within 13 weeks, with side effects like nausea typically subsiding after the titration phase.

A structured primary care intervention combining a phased caloric-restricted diet (initially low-carbohydrate) and progressive aerobic activity, delivered via frequent GP visits, produces statistically significant weight loss (≥5% and ≥10%) compared to usual care in patients with obesity.

If you have obesity, ask your doctor for a structured plan rather than general advice. Look for programs that include frequent check-ins, a written diet guide, and a specific exercise goal. The study showed that a strict 4-week start followed by a balanced diet and daily walking/cycling, managed by your doctor, leads to better weight loss than standard care.

Sedentary lifestyle and insufficient physical activity are significant behavioral factors contributing to obesity by reducing energy expenditure.

Increase daily movement by taking short walks, standing more, or doing light exercises during breaks. Aim for at least 30 minutes of physical activity per day to help control weight.

Dietary factors, including high consumption of refined grains, sugar, fats, and liquid calories, contribute to obesity by increasing caloric intake.

Reduce consumption of sugary beverages, processed foods, and refined grains. Focus on whole foods, fruits, vegetables, and whole grains to manage caloric intake and improve health.

Newer obesity management medications (OMMs), specifically semaglutide (2.4 mg) and tirzepatide (10-15 mg), demonstrate high efficacy comparable to metabolic bariatric surgery (MBS) in the short term (26-52 weeks), with tirzepatide achieving >15% TBWL.

For those seeking non-surgical weight loss, newer medications like semaglutide (2.4 mg) and tirzepatide (10-15 mg) are the most effective options available, with tirzepatide showing short-term weight loss (15.2%) comparable to surgical procedures. These require weekly administration and are generally more effective than older medications like orlistat. They are best used in conjunction with lifestyle interventions.

Combining exercise with pharmacotherapy (specifically GLP-1 agonists or orlistat) significantly enhances weight loss, BMI reduction, and body fat percentage compared to exercise alone in overweight/obese adults.

If you are overweight or obese, adding a prescribed weight-loss medication (like GLP-1 agonists or orlistat) to your regular exercise routine will likely result in greater weight and fat loss than exercising alone. While exercise is foundational, medication can help overcome compensatory mechanisms like increased appetite, leading to more significant improvements in body composition.

A modified-release combination of orlistat (120 mg) and acarbose (40 mg) produces significantly greater weight loss (mean -7.73%) compared to modified-release orlistat alone (-5.78%) or conventional orlistat (-5.13%) over 26 weeks.

Take the specific combination pill (EMP16) containing 120mg modified-release orlistat and 40mg modified-release acarbose daily with meals for 6 months. Follow a diet limiting fat to 30% of calories and focusing on low-glycemic foods. Expect roughly 7.7% body weight loss, which is significantly better than taking orlistat alone.

Low-calorie diets (1,000–1,500 kcal/day) are a foundational, guideline-recommended intervention for obesity management, though weight loss plateaus after 6 months.

Start with a daily intake of 1,000 to 1,500 calories, or a 500-750 calorie deficit, as recommended by major guidelines. Expect the most significant weight loss in the first 6 months, but plan for a maintenance phase afterward. Work with a nutritionist to ensure the diet fits your preferences to improve adherence.

Reducing overall carbohydrate intake, particularly to very low-carbohydrate levels (<26% of calories), demonstrates the most evidence for improving glycemia (A1C) and reducing medication needs in adults with type 2 diabetes, especially in the short term (3-6 months).

If you have type 2 diabetes and struggle with blood sugar control, try reducing your carbohydrate intake. Very low-carb diets (under 26% of calories) often lower A1C faster in the first few months. However, you must work with your doctor to adjust your diabetes medications to avoid low blood sugar. This approach is viable for many, but long-term results may be similar to other healthy diets.

Adhering to five low-risk lifestyle factors (never smoking, moderate alcohol, high diet quality, normal BMI, and regular physical activity) significantly increases life expectancy compared to having zero such factors.

To maximize your life expectancy, aim to adopt five specific habits: never smoke, maintain a BMI between 18.5 and 24.9, eat a diet high in vegetables, fruits, nuts, whole grains, and healthy fats (upper 40% of AHEI), limit alcohol to 5-15g/day (women) or 5-30g/day (men), and exercise for at least 3.5 hours per week at a moderate-to-vigorous intensity. Doing all five can add up to 14 years to your life compared to having none.

Regular physical activity improves whole-body insulin sensitivity (SI) through both acute mechanisms (AMPK/TBC1D1-mediated GLUT4 translocation during exercise) and chronic adaptations (increased capillarization and beta-cell function), with high-intensity interval training (HIIT) and sprint interval training (SIT) offering superior or time-efficient benefits compared to moderate continuous exercise.

To improve insulin sensitivity, aim for regular physical activity. While moderate continuous exercise is effective, incorporating High-Intensity Interval Training (HIIT) or Sprint Interval Training (SIT) may offer time-efficient benefits, especially for those with prediabetes or obesity. Consistency is key, as acute improvements in insulin sensitivity can last up to 72 hours but are lost if exercise stops for 5 days. Focus on both aerobic and resistance exercises for comprehensive glycaemic regulation.

Consuming casein protein (~30-40 g) before sleep increases muscle protein synthesis and metabolic rate overnight without affecting lipolysis.

If you want to support muscle growth overnight, have 30-40 grams of casein protein (like cottage cheese or a casein shake) right before bed.

Increasing daily dietary fibre intake to 35 grams (or by 15 grams from baseline) significantly reduces all-cause mortality, improves glycaemic control (HbA1c), and lowers cardiometabolic risk factors in adults with prediabetes or diabetes.

To manage diabetes and reduce mortality risk, aim to consume 35 grams of dietary fibre daily, or add 15 grams to your current intake. Focus on whole grains and fibre-rich foods without needing to restrict other macronutrients. This change is associated with fewer deaths and better blood sugar control.

Increasing dietary fibre intake significantly improves glycaemic control, reducing HbA1c by a mean difference of -2.00 mmol/mol and fasting plasma glucose by -0.56 mmol/L in adults with diabetes.

If you have diabetes, increasing your fibre intake can help lower your HbA1c and fasting blood sugar. You do not need to cut out carbohydrates; instead, choose carbohydrate sources that are high in fibre, such as whole grains and vegetables.

Replacing processed carbohydrates (high GI/GL grains, potatoes, added sugars) with unprocessed carbohydrates (whole grains, legumes, whole fruits) or healthy fats reduces the risk of obesity, type 2 diabetes, and cardiovascular disease.

Focus on the quality of your carbohydrates rather than just cutting them out. Swap refined grains, potatoes, and sugary drinks for whole grains, legumes, and whole fruits. This shift is strongly linked to better metabolic health and lower disease risk.

Higher intake of trans fatty acids (TFA) is associated with a significantly increased risk of cardiovascular disease (CVD) in a dose-response manner.

Avoid trans fatty acids. This meta-analysis confirms that higher TFA intake increases CVD risk, with a 16% increase in risk for every 2% of daily energy intake from TFA. Unlike total fat, saturated fat, or unsaturated fats, TFA shows a clear harmful dose-response relationship.

Intermittent fasting and time-restricted eating are effective weight loss strategies comparable to daily calorie restriction.

Try intermittent fasting (like 16:8 time-restricted eating or 5:2 fasting) if you struggle with counting calories. It helps restrict intake by limiting the eating window. Be aware of side effects like dizziness, especially if you take diabetes medication.

High-protein diets (1-1.2 g/kg/day) aid in weight loss maintenance by increasing satiety and preserving lean body mass.

To maintain your weight loss, aim for 1-1.2 grams of protein per kilogram of your ideal body weight daily. This helps you feel full and keeps your muscle mass. If you have kidney disease, consult your doctor first.

Carbohydrate intake should be periodized ('fuel for the work required') based on the daily fuel cost of exercise rather than a fixed macronutrient ratio, ensuring high availability for high-intensity/long-duration sessions and lower availability for low-intensity/short sessions.

Stop counting carbs as a fixed percentage of your diet. Instead, match your carbohydrate intake to your daily training load. On heavy training days or long sessions, eat more carbs. On rest days or light recovery sessions, eat fewer carbs. This is called 'fueling for the work required'.

High carbohydrate availability is required for sessions involving higher intensity workloads, optimal performance, or maximizing recovery, whereas low carbohydrate availability may be sufficient for light or low-moderate intensity exercise.

Eat high carbohydrates before and during hard workouts, long runs, or races to ensure you can perform well and recover. On easy recovery days or short light sessions, you can eat fewer carbohydrates without compromising performance.

Tirzepatide demonstrates greater comparative weight loss and metabolic benefits than semaglutide in real-world observational studies, particularly in patients without pre-existing diabetes.

If you are using Semaglutide and not achieving your weight loss goals, switching to Tirzepatide may result in greater weight loss and better metabolic outcomes, especially if you do not have Type 2 Diabetes. Real-world data suggests Tirzepatide is more potent than Semaglutide in routine practice.