Browse the evidence

Engagement with a nutritionist is a significant independent predictor of achieving relevant weight loss (≥7% and ≥10%) in MASLD patients, even when controlling for baseline BMI and other comorbidities.

If you have MASLD, seeking help from a qualified nutritionist significantly increases your chances of losing enough weight to improve your liver health. The study shows that patients who worked with a nutritionist were nearly 4 times more likely to lose 10% or more of their body weight. Make this a priority in your care plan.

GLP-1 receptor agonists (GLP-1RAs) as adjunctive therapy to insulin significantly reduce body weight, HbA1c, and total daily insulin requirements in patients with type 1 diabetes and overweight or obesity.

If you have Type 1 Diabetes and are overweight, adding a GLP-1RA (like semaglutide or liraglutide) to your insulin regimen can help you lose weight (average 4-6 kg), lower your HbA1c slightly, and significantly reduce your daily insulin needs (by ~9 units). This is generally safe, though you may experience temporary nausea and a slightly higher risk of low blood sugar, which can be managed by adjusting your insulin dose.

Semaglutide demonstrates superior efficacy in reducing body weight, HbA1c, and insulin requirements compared to other GLP-1RAs (liraglutide, exenatide) in patients with Type 1 Diabetes.

Among GLP-1RAs, semaglutide (1.0 mg weekly) appears to be the most effective option for Type 1 Diabetes patients, offering greater weight loss (~6 kg) and insulin reduction (~15 units/day) compared to liraglutide or exenatide. Discuss with your provider if you are a candidate for this specific agent.

Orforglipron, an oral non-peptide GLP-1 receptor agonist, produces dose-dependent reductions in body weight (up to 9.8% at 45 mg) and waist circumference, with maximal efficacy observed at higher doses (24-45 mg).

Orforglipron is an oral medication that helps obese adults lose weight and improve metabolic markers like blood sugar and cholesterol. It works by mimicking a natural hormone (GLP-1) to reduce appetite and slow digestion. The higher the dose (up to 45 mg daily), the more weight is lost, with studies showing up to 9.8% body weight reduction. However, higher doses also increase the risk of stomach issues like nausea and diarrhea, which may lead some patients to stop taking it. It is taken once daily without strict fasting requirements, making it more convenient than some injectable alternatives.

Lifestyle interventions (diet and exercise) are effective in preventing or delaying Type 2 Diabetes in high-risk groups, including those with a history of GDM, but adherence remains a significant barrier.

For women with a history of GDM, aiming for 150 minutes of physical activity per week combined with dietary changes is the most effective way to prevent Type 2 Diabetes. Structured programs offering health coaching and group support can improve adherence and outcomes. Regular monitoring of HbA1c and fasting plasma glucose is recommended.

Treatment with semaglutide 2.4 mg for overweight or obesity leads to a statistically significant reduction in the need for concomitant antihypertensive and lipid-lowering medications compared to placebo, primarily through weight-loss-mediated improvements in blood pressure and lipid profiles.

If you are taking medication for high blood pressure or high cholesterol, significant weight loss achieved through semaglutide 2.4 mg may allow your doctor to safely lower your dose or stop the medication entirely. This is not automatic; it requires active monitoring by your healthcare provider to ensure your blood pressure and lipids remain in a healthy range without the drugs. Do not stop these medications on your own.

Intentional weight loss achieved through lifestyle interventions, antiobesity medications, or bariatric surgery reduces the incidence of obesity-associated cancers, particularly hormone-dependent malignancies in postmenopausal women.

If you have overweight or obesity, achieving and maintaining a weight loss of at least 5% of your body weight can significantly reduce your risk of developing certain cancers, especially in postmenopausal women. This can be achieved through lifestyle changes (diet and exercise), medications, or surgery. The key is sustained loss, not just short-term dieting.

Protein supplementation combined with resistance exercise increases muscle mass and strength, but intakes above 1.6 g/kg body weight per day provide no additional significant gains.

To build muscle, combine resistance training with protein intake of 1.6 g/kg body weight per day. Eating more protein than this does not provide additional muscle or strength gains.

Lifestyle interventions (caloric restriction and physical activity) reduce the risk of incident chronic kidney disease in obese diabetic patients by approximately 30% compared to standard care.

If you are overweight and have diabetes, combining a healthier diet with regular physical activity can cut your risk of developing kidney disease by 30%. This is a highly effective, drug-free way to protect your kidneys.

Intensive, frequent dietitian-supported nutritional education significantly reduces total energy and carbohydrate intake in patients with type 2 diabetes compared to standard annual education.

For patients with Type 2 Diabetes, especially those with kidney issues, seeing a dietitian frequently (at every visit) is more effective for reducing calorie and carb intake than seeing them once a year. This frequent support helps patients make better food choices, such as eating more fish and fewer sweets, leading to significant reductions in total energy intake over two years.

Higher protein diets during weight loss improve glycemic variables (fasting triglycerides and insulin) compared to standard protein diets, with benefits persisting to some degree long-term.

When losing weight, choosing a diet with higher protein content can help improve your metabolic health, specifically by lowering fasting triglycerides and insulin levels. This benefit may persist even after the diet ends. Focus on increasing protein intake as part of a balanced approach to weight loss.

Phenotype-guided pharmacotherapy using naltrexone/bupropion extended-release (NB-ER) is the preferred treatment for obesity patients with emotional hunger, as it addresses both weight and depression symptoms.

If you struggle with emotional eating and depression, ask your doctor about NB-ER (naltrexone/bupropion). It is specifically shown to help with both weight loss and mood in this subgroup, unlike many standard antidepressants which may cause weight gain.

GLP-1 receptor agonists (liraglutide, semaglutide, tirzepatide) are effective for weight loss in patients with obesity and may improve depression scores, with a low rate of adverse psychiatric events.

GLP-1 agonists (like Semaglutide or Tirzepatide) are highly effective for weight loss (15-21%) and may also improve depression. They have a low risk of psychiatric side effects. Discuss these with your doctor if you have no thyroid cancer history.

Semaglutide (2.4 mg once-weekly) produces significant, sustained weight loss (10-15%) and improves cardiometabolic markers in non-diabetic individuals with obesity or overweight, primarily by mimicking GLP-1 to reduce appetite and energy intake.

If you have obesity or are overweight without diabetes, semaglutide (2.4 mg weekly) is a highly effective medical treatment that can help you lose 10-15% of your body weight and improve your metabolic health. It works by reducing your appetite. While it can cause temporary stomach issues like nausea, these often subside. It works best when combined with diet and exercise, but it is significantly more effective than lifestyle changes alone for substantial weight loss.

GLP-1 receptor agonists (semaglutide) and dual incretin agonists (tirzepatide) achieve 15-20% total body weight loss, rivaling the efficacy of bariatric surgery.

If you have obesity, these medications offer a powerful, non-surgical path to significant weight loss (15-20%). They require a weekly injection and likely lifelong use, but they can improve metabolic health and may be more accessible than surgery for some. Discuss with your doctor if you are a candidate.

GLP-1 receptor agonists (semaglutide and tirzepatide) produce significantly greater average weight loss (14.9% and 18.5%, respectively) than physicians estimate (9.22%), and are associated with high rates of gastrointestinal side effects (80-90%) that are significantly underestimated by prescribers.

If you are prescribing GLP-1 agonists, ensure you are counseling patients on the high likelihood of gastrointestinal side effects (up to 90%) and the significant magnitude of weight loss (15-18%). Underestimating these factors leads to poor adherence and unrealistic expectations.

Health Behavior Intervention (HBI) consisting of 13 dietician-led counseling sessions over 1 year is a cost-effective strategy for managing class III obesity compared to no treatment.

For individuals with class III obesity, engaging in 13 dietician-led counseling sessions over a year is a cost-effective way to manage weight and prevent complications, especially if surgery is not an option.

Incretin medications (GLP-1 RAs and dual agonists) are the most effective class of AOMs for older adults, achieving 15-25% weight loss, but require careful titration to manage side effects.

Incretin drugs like Semaglutide and Tirzepatide are currently the most effective weight loss medications for older adults, often resulting in 15-25% body weight loss. They work by mimicking gut hormones to reduce hunger. Doctors usually start with a low dose to minimize side effects like nausea and gradually increase it.

Achieving a 5% weight loss over one year results in substantial direct medical cost savings for people with obesity, with savings increasing alongside higher obesity severity.

You do not need to achieve massive weight loss to see financial benefits. Losing just 5% of your body weight within a year can lead to substantial savings in direct medical costs, with the greatest savings seen in those with higher obesity severity (Class II and III). Focus on achieving this modest, sustainable reduction.

Phentermine/topiramate and naltrexone/bupropion are effective alternative pharmacotherapies for weight loss (4-10%) in patients without cardiovascular contraindications, offering oral administration options.

If you cannot take or afford weekly injections, oral medications like phentermine/topiramate or naltrexone/bupropion are effective alternatives. They typically result in 4-10% weight loss. Side effects like nausea or insomnia are common but often improve over time, especially if you start with a low dose and increase slowly. These are not suitable if you have heart disease, high blood pressure, or a history of seizures.

Resistance training over a full range of motion is superior to partial range of motion for hypertrophy.

To build the most muscle, perform your exercises through a full range of motion. Partial reps are less effective for hypertrophy.

Supplementation with 5g/day spinach-derived thylakoid membranes combined with a hypo-caloric diet significantly improves atherogenic indices (AIP, CRI-I, CRI-II) and insulin resistance surrogates (TyG-BMI, METS-IR) in obese women with PCOS compared to placebo.

If you have PCOS and are overweight, adding 5 grams of spinach thylakoid extract daily to your calorie-restricted diet may help improve your blood vessel health markers and insulin sensitivity more than dieting alone. Take it 30 minutes before lunch.

Tirzepatide (5, 10, or 15 mg once weekly) provides significantly longer continuous time in glycaemic control (HbA1c <7.0% and ≤6.5%) and sustained body weight reduction (≥5%) compared to placebo, semaglutide 1 mg, and insulin therapies in patients with type 2 diabetes.

For patients with Type 2 Diabetes, tirzepatide (5, 10, or 15 mg once weekly) offers significantly longer periods of stable blood sugar (HbA1c <7.0%) and sustained weight loss (≥5%) compared to placebo, semaglutide 1 mg, and insulin therapies. This suggests that tirzepatide may provide more durable disease management with fewer hypoglycaemic events than insulin.

A combined high-protein (25% energy) and low-glycemic-index (LGI) diet is superior to low-protein/high-GI diets for maintaining weight loss and improving insulin resistance (measured by TyG index) after an initial energy-restricted weight loss.

If you have recently lost weight, switch to a maintenance diet that is high in protein (around 25% of calories) and low in glycemic index (low-GI carbs). This specific combination helps you keep the weight off longer and improves insulin sensitivity better than diets low in protein or high in glycemic index. You do not need to count calories strictly; focus on the quality of your protein and carbohydrate sources.