Browse the evidence

High carbohydrate intake (61% of energy) is associated with lower total mortality and cardiovascular events compared to high fat intake (23.5% of energy).

Focus on the quality of your diet rather than just cutting fat. The PURE study suggests that a diet with higher carbohydrates and lower fat (as traditionally practiced in many parts of the world) may be associated with better health outcomes than high-fat diets. However, this does not mean you should consume excessive amounts of refined sugars or processed foods. Instead, prioritize whole food sources of carbohydrates and healthy fats.

High-volume static stretching (≥15 minutes per muscle group, >3 times per week) induces muscle hypertrophy and strength increases comparable to resistance training, primarily by generating high-magnitude mechanical tension that activates mTOR/p70S6K signaling pathways.

If you cannot lift weights due to injury, age, or lack of equipment, perform static stretches for at least 15 minutes per muscle group, 3 or more times a week. Push to the point of discomfort (but not sharp pain). This can build muscle and strength similarly to weightlifting, though it takes longer per session. It is particularly useful for immobilized patients or as a supplement to your regular workouts.

High-volume static stretching improves glycemic control (post-prandial glucose and HbA1c) in individuals with Type 2 Diabetes, potentially by increasing GLUT-4 translocation via AMPK and CaMK pathways.

If you have Type 2 Diabetes, incorporating static stretching into your routine may help lower blood sugar levels, especially after meals. It works by helping your muscles take up glucose without needing as much insulin. It is not a replacement for medication but a helpful addition.

Inter-set palm or sole cooling (10-15°C for 1-3 minutes) may acutely enhance resistance training volume capacity and maximal strength, though evidence is mixed and methodologically limited.

If you want to try inter-set cooling, use 10-15°C cooling on your palms (for upper body) or soles (for lower body) for 1-3 minutes between sets. You can use cold water buckets or ice packs. Be aware that results are inconsistent; some people may see increased volume or strength, while others see no change. It is not a guaranteed performance enhancer, but it is low-risk and may help some individuals tolerate more volume.

Training with 4-6 or 1-3 repetitions in reserve (RIR) yields comparable strength gains, whereas training to momentary failure (0 RIR) or near-failure (0-3 RIR) results in slightly inferior strength outcomes in trained men.

For strength gains, you do not need to train to failure. Stopping sets with 1-3 reps left in the tank (RIR) produces similar or better strength results than going to failure. Training to failure may actually hinder strength progress due to excessive fatigue and reduced recovery capacity. Focus on maintaining bar speed and consistency rather than absolute exhaustion.

Training sets to submaximal proximities of failure (4-6 RPE or 7-9 RPE) yields strength gains comparable to training with higher proximities, while training to momentary failure (10 RPE) may result in slightly inferior strength outcomes.

You do not need to train to failure to get strong. Training sets to 4-6 or 7-9 RPE (leaving 4-9 reps in reserve) produces strength gains similar to each other. Training to absolute failure (10 RPE) may actually hinder strength progress due to excessive fatigue. Focus on maintaining barbell velocity and managing recovery rather than grinding out every last rep.

Weight-neutral nutrition and exercise counseling can improve insulin sensitivity in patients with stage 1 obesity, as measured by the Quantitative Insulin Sensitivity Check Index (QUICKI).

If you have stage 1 obesity and metabolic issues, try focusing on improving diet quality (more fiber, less sodium, healthy fats) and increasing physical activity without stressing about the number on the scale. This approach can improve your insulin sensitivity for some people, even if you don't lose weight.

Metformin augmentation for non-responders to initial behavioral interventions provides a potential rescue effect but is associated with gastrointestinal side effects that challenge adherence.

If behavioral changes alone don't improve your insulin sensitivity, adding metformin might help, but be prepared for potential stomach issues. Starting with a low dose and using extended-release versions can help manage side effects.

Psychological distress (stress, anxiety, depression) and environmental barriers (food insecurity, poor neighborhood quality) significantly increase the risk of weight regain after intentional weight loss by driving disinhibited eating and reducing behavioral adherence.

If you are struggling to maintain weight loss, look beyond just calories. Assess your stress levels, mental health, and your physical environment (food access, neighborhood safety). High stress and poor food environments are proven drivers of weight regain. Addressing these external and psychological factors is essential for long-term success, not just willpower.

Impulsiveness (measured by BIS-11 and MCQ) and temporal discounting (preference for immediate rewards) are significant predictors of weight regain, as they correlate with higher caloric intake and poor adherence to dietary restrictions.

If you find it hard to stick to your diet, it might not just be a lack of discipline. Your brain's tendency to prefer immediate rewards (like tasty food) over long-term goals (like health) plays a role. Recognizing this 'impulsiveness' can help you implement strategies to manage it, such as removing triggers or planning ahead.

Metabolic adaptation (energy expenditure below expected levels) and appetite adaptation (increased energy intake) are coregulated and inseparable factors in weight regain.

Don't try to fix weight maintenance by only focusing on diet or only on exercise. Your body's hunger signals and energy burn are linked. Effective long-term strategies need to address both sides of the energy balance equation simultaneously.

Maintaining weight loss induced by anti-obesity drugs may require lifelong use unless effective adjunct strategies for weight maintenance are available.

If you use medication for weight loss, understand that it may need to be long-term. This is similar to managing other chronic conditions. The goal of research like POWERS is to find adjunct strategies that might reduce this dependency.

Self-selection of behavioral weight loss programs (DPP vs. HWL) in adults with obesity results in balanced enrollment (approx. 50/50 split) without significant bias from BMI, age, or baseline health conditions, though race, income, education, and prior weight loss history do influence program preference.

If you are designing or choosing a weight loss program, offering a choice between different behavioral models (e.g., strict logging vs. biological focus) does not inherently break the study or skew results. However, be aware that race, income, education, and past weight loss history may influence which program a participant prefers. Matching the program to these factors may improve initial engagement.

GLP-1 receptor agonists (Liraglutide, Semaglutide) and dual agonists (Tirzepatide) are viable and promising options for weight loss in people living with HIV, with minimal drug-drug interaction risks compared to Orlistat.

GLP-1 agonists like Liraglutide and Semaglutide are effective and generally safe for people with HIV, with fewer drug interactions than older drugs like Orlistat. They require injections (or new oral forms in development). Discuss these options with your provider if lifestyle changes alone are insufficient.

Mazindol, an anorexiant approved in Japan for short-term weight loss, significantly reduces body weight and total cholesterol compared to placebo in Japanese adults with obesity, but is associated with higher adverse event rates.

For Japanese adults with obesity, mazindol is an approved short-term treatment that significantly reduces body weight and total cholesterol compared to placebo. It acts by suppressing appetite. Patients should be aware of higher adverse event rates and the need for short-term use.

Semaglutide treatment in patients with chronic ankle instability (CAI) significantly improves patient-reported functional outcomes (FAAM, FAOS, CAIT) and reduces the incidence of recurrent ankle sprains and surgery, with approximately one-third of the benefit mediated by weight loss.

For patients with chronic ankle instability, especially those who are overweight or have type 2 diabetes, semaglutide may offer benefits beyond metabolic control. It is associated with improved ankle function, fewer sprains, and lower surgery rates. While weight loss contributes to this, it is not the only factor. Patients should discuss this potential orthopedic benefit with their prescribing physician, particularly if they are considering surgical intervention for ankle instability.

Higher body mass index (BMI) is associated with lower self-reported physical functioning and overall health-related quality of life (HRQoL) in people with overweight or obesity.

If you have overweight or obesity, you are statistically more likely to experience reduced physical functioning and lower quality of life as your BMI increases. This is not just about appearance; it affects your daily physical capacity and general health perception. Addressing weight and associated comorbidities is a key lever for improving these functional outcomes.

The presence of cardiovascular (CV) or metabolic comorbidities significantly reduces health-related quality of life (HRQoL) and work productivity in people with overweight or obesity, independent of BMI alone.

Having overweight or obesity is not the only factor affecting your health and work. If you have cardiovascular or metabolic conditions (like diabetes or high blood pressure), these significantly impact your quality of life and productivity. Treating these comorbidities alongside weight management is crucial for improving your daily well-being.

People with overweight or obesity experience significant work productivity impairment, particularly in terms of presenteeism and activity impairment, when they have metabolic comorbidities.

If you have overweight or obesity and metabolic conditions like diabetes, you may experience reduced work effectiveness (presenteeism) and activity limitation. This is a measurable impact of your health conditions. Managing these conditions can help improve your work productivity and overall well-being.

Semaglutide use for rapid weight loss causes 'semaglutide face,' characterized by facial hollowing, skin sagging, and premature aging due to subcutaneous fat loss, collagen depletion, and muscle mass reduction.

If you are using semaglutide for weight loss, be aware that rapid fat and muscle loss can cause your face to look hollow or sagged. This is a known side effect called 'semaglutide face.' You can discuss preventative or corrective measures like dermal fillers, PRP, or radiofrequency microneedling with your provider to maintain your appearance while losing weight.

Lifestyle modifications (diet, exercise, behavioral therapy) are foundational but have limited efficacy for severe obesity when used alone.

Lifestyle changes (diet, exercise, counseling) are the foundation of obesity treatment. However, for severe obesity (BMI ≥35), they are often not enough on their own. Combine them with medical or surgical options for best results.

GLP-1 receptor agonists (GLP-1RAs) are perceived by primary care providers as effective and promising tools for managing recurrent weight gain after metabolic bariatric surgery (MBS), offering renewed optimism and life-changing results for patients.

If you have had bariatric surgery and are regaining weight, GLP-1 medications like semaglutide are a viable and effective option to help you lose weight again. However, they are not a magic bullet; you must continue to focus on diet and exercise. The main barrier is cost, so work with your provider to navigate insurance coverage or assistance programs.

GLP-1 receptor agonists (e.g., semaglutide, tirzepatide) significantly suppress hunger, reduce 'food noise' (intrusive thoughts about food), and increase early satiety during the dynamic weight loss phase, leading to reduced portion sizes and cravings.

When starting GLP-1 medications, expect a significant reduction in hunger and intrusive thoughts about food ('food noise'). This is a biological effect, not just willpower. You may feel full faster and eat smaller portions. This effect is strongest in the first few months (dynamic phase). If you stop the medication, hunger and food noise typically return, so long-term adherence is often necessary for sustained benefits.

Bariatric surgery, particularly Roux-en-Y gastric bypass (RYGB), significantly improves psoriasis symptoms and quality of life, with effects potentially linked to increased GLP-1 levels post-surgery.

If you have severe obesity and psoriasis, and lifestyle changes plus medications haven't worked, bariatric surgery (especially gastric bypass) can be a powerful option. It not only helps with weight but can significantly improve your psoriasis symptoms, likely by boosting your body's natural GLP-1 levels. This is a major step, so it's reserved for those with higher BMI or uncontrolled comorbidities.