Browse the evidence

Lifestyle interventions, specifically the Mediterranean diet and moderate-to-vigorous exercise, improve psoriasis symptoms and quality of life, independent of weight loss.

Start with lifestyle changes. Adopt a Mediterranean diet, which has anti-inflammatory properties that can help your psoriasis regardless of weight loss. Aim for 150 minutes of moderate exercise per week, plus strength training. If sweating bothers your skin, try swimming or other low-impact activities. Be patient and gradual to avoid discouragement.

Triple receptor agonists (GLP-1/GIP/Glucagon) such as retatrutide achieve superior weight loss (20-24%) compared to single or dual agonists by synergistically combining satiety, nutrient partitioning, and increased energy expenditure.

If you are struggling with current GLP-1 therapies or need more aggressive weight loss, triple-agonist medications like retatrutide are the next step. They work by hitting three metabolic targets at once, leading to much higher weight loss (up to 24%) than standard drugs. This is currently an injectable treatment, but oral alternatives are being developed.

Oral GLP-1 receptor agonists (e.g., orforglipron) provide comparable efficacy to injectable formulations while improving accessibility by eliminating cold-chain requirements.

If you prefer pills over injections, oral GLP-1 medications like orforglipron are a viable option. They work similarly to shots but are taken daily by mouth, which may help you stick with the treatment longer. They are also easier to store and distribute globally.

Combining amylin analogs (e.g., cagrilintide) with GLP-1 agonists (e.g., semaglutide) achieves weight loss (20-22%) through distinct neuroendocrine circuits, offering a tolerability advantage over single agents.

If you are not getting enough weight loss or side effects from GLP-1s alone, adding an amylin analog (like cagrilintide) to your regimen might help. This combination works through a different mechanism in your brain and gut, leading to significant weight loss (around 20%) and potentially better tolerability.

Body composition-targeted agents (e.g., bimagrumab) preserve or increase lean mass while reducing fat mass, addressing the functional decline associated with rapid weight loss.

If you are concerned about losing muscle while losing weight, ask your doctor about body composition-targeted therapies. Drugs like bimagrumab are designed to burn fat while building or preserving muscle, which helps maintain strength and function.

Testosterone Replacement Therapy (TRT) increases lean body mass and improves body composition in men with documented low testosterone, but no trials have evaluated its combined use with GLP-1 RAs.

If you are a man with low testosterone, TRT can help preserve muscle. However, doctors should check your levels before starting, and there is no proof yet that taking TRT alongside GLP-1s prevents muscle loss better than TRT alone.

A 5-10% weight loss in adults is often sufficient to obtain substantial health benefits from decreasing obesity-related comorbidities, challenging the goal of maximum weight loss in the shortest time.

You do not need to lose a massive amount of weight to see major health improvements. Losing just 5-10% of your body weight can significantly reduce obesity-related health risks. Focus on achieving this sustainable target rather than aiming for rapid, maximum weight loss.

The Russian semaglutide-based drug Velgia® (WRYC12301) demonstrates bioequivalence, high safety, and lack of immunogenicity compared to the reference drug Wegovy® at doses of 0.25 mg and 2.4 mg.

This study confirms that the Russian semaglutide product Velgia® is bioequivalent to the brand-name Wegovy® at both 0.25 mg and 2.4 mg doses. It has a comparable safety profile with mild side effects and no detected immunogenicity (antibody formation). For patients seeking this treatment, this generic option offers the same pharmacokinetic exposure as the reference drug.

Subsidized participation in commercial weight management programs improves engagement and reduces attrition compared to non-subsidized participation, without compromising weight loss outcomes.

If you cannot afford a commercial weight loss program, look for subsidies from your health insurance or employer. Financial assistance can make these programs more accessible and help you stay engaged without increasing your out-of-pocket costs.

Technology-assisted obesity interventions, including digital platforms and AI-driven adaptive interventions, can produce clinically meaningful weight loss and improve equity by increasing reach to marginalized populations.

Digital weight loss programs can be effective and affordable. If you have a smartphone, you may have access to these programs. Look for options that offer human support if you need extra motivation, as combining technology with coaching yields better results.

Supplementation with specific probiotics (e.g., Lactobacillus gasseri SBT2055, Lactobacillus curvatus HY7601, and Lactobacillus plantarum KY1032) reduces abdominal adiposity and body weight in overweight or obese individuals.

Consuming fermented milk containing specific probiotic strains like Lactobacillus gasseri SBT2055 (10^8 cfu/day) may help reduce abdominal fat in adults with large visceral fat areas.

Prebiotic supplementation (inulin, oligofructose, galactooligosaccharides) modulates gut microbiota (increasing Bifidobacterium) and improves metabolic markers in overweight or obese individuals.

Supplementing with prebiotics like inulin or oligofructose (e.g., 50/50 mix) for 16 weeks can help reduce body fat and trunk fat in overweight or obese individuals, including children, by improving gut microbiota composition.

Discontinuation of semaglutide or tirzepatide prior to pregnancy leads to expected weight regain, which may cause fetal macrosomia and negate the metabolic benefits of prior weight loss.

If you are using semaglutide or tirzepatide and planning pregnancy, you must stop the medication 1-2 months before trying to conceive. Be aware that you will likely regain some weight during this time, which can increase the risk of the baby being too large (macrosomia). To minimize this, focus on strength training and high-protein nutrition immediately after stopping the drug.

In integrated primary care weight management, achieving clinically meaningful weight loss (≥5% initial body weight) is significantly associated with higher treatment visit frequency and the simultaneous prescription of two or more anti-obesity medications (AOMs).

To maximize your chances of losing at least 5% of your body weight, commit to attending your scheduled monthly appointments for the first six months and discuss with your doctor the potential benefit of using two anti-obesity medications simultaneously if one isn't working. Consistent engagement and combination therapy were key factors in successful weight loss trajectories in this study.

A history of metabolic surgery (specifically sleeve gastrectomy) significantly attenuates the weight-loss efficacy of liraglutide in patients with mild obesity, resulting in substantially lower total weight loss compared to non-surgical patients.

If you have had weight-loss surgery (especially sleeve gastrectomy), standard doses of liraglutide may not work as well as they do for others. Your doctor might need to increase your dose to 3.0 mg (if approved/available) or switch you to a different medication like tirzepatide to achieve similar weight loss results. Do not assume the standard dose will be sufficient.

Systematic screening for heart failure with preserved ejection fraction (HFpEF) in asymptomatic or mildly symptomatic individuals with obesity is clinically indicated to enable early detection and intervention, as obesity-related HFpEF presents with distinct pathophysiology and earlier onset.

If you have obesity, do not assume shortness of breath or fatigue is 'just part of being overweight.' Ask your doctor about screening for heart failure with preserved ejection fraction (HFpEF), especially if you have other risk factors like high blood pressure or atrial fibrillation. Early detection through specific tests (like echocardiograms or biomarker adjustments) can allow for treatments that prevent heart failure from developing.

Tirzepatide maintenance therapy (either at maximum tolerated dose or reduced to 5 mg) is designed to prevent the weight regain seen with placebo, with rescue protocols available for significant regain.

This paper outlines a trial testing if you can stay on a lower dose of tirzepatide (5mg) or stay on your highest effective dose to keep weight off, compared to stopping it. It also includes a safety net: if you regain more than half your lost weight, you get 'rescue' treatment.

Tirzepatide use is associated with a significantly lower risk of suicidal ideation or suicide attempts compared to other anti-obesity medications in a real-world cohort.

Current real-world evidence suggests that tirzepatide is not associated with an increased risk of suicide and may be associated with a lower risk compared to other anti-obesity medications. However, because this is an observational study, it does not prove causation. Patients with a history of suicidality were excluded, so this data does not apply to high-risk individuals. Consult your provider for personalized psychiatric risk assessment.

GLP-1 receptor agonist therapy for obesity effectively supports weight loss and improves quality of life, but long-term sustainability is undermined by high medication costs, inadequate multidisciplinary support, and significant side effects leading to discontinuation.

GLP-1 medications like Tirzepatide and Semaglutide are effective for weight loss and improving quality of life for many users. However, long-term success is not guaranteed. High costs and side effects are the main reasons people stop treatment. If you are considering or using these medications, be aware that discontinuation often leads to weight regain. Ensure you have a plan for managing costs and side effects, and consider seeking multidisciplinary support (dietary, psychological) to improve adherence and sustainability.

Tirzepatide, a dual GIP/GLP-1 receptor agonist, achieves superior weight loss and hepatic steatosis reduction compared to semaglutide, with preliminary cardiovascular non-inferiority data.

If you have Type 2 Diabetes and fatty liver disease, ask your doctor about Tirzepatide. It is a newer medication that has shown superior weight loss and liver fat reduction compared to other GLP-1 drugs. While cardiovascular outcome data is still being finalized, it is a powerful option for managing both conditions.

Initiating anti-obesity medications more than 12 months after bariatric surgery is associated with a significantly lower risk of adverse events compared to initiation within the first 12 months.

If you are considering weight loss medication after bariatric surgery, current evidence suggests it may be safer to wait until at least 12 months have passed since your surgery. Starting medication earlier is associated with a much higher risk of adverse events, though this may be partly due to the natural recovery period of the surgery itself rather than the drug alone.

Caffeine supplementation, while beneficial for endurance performance, may impair shooting accuracy in biathletes and should be used with caution.

Be cautious with caffeine. While it helps you ski faster, it might make your shooting less accurate. Test it in training to see how it affects your specific shooting performance before using it in competition.

Biathletes should monitor iron and vitamin D levels, as deficiencies are common in endurance sports and can impair performance and health, even if general micronutrient deficiencies are less common in biathletes due to high caloric intake.

Get your iron and vitamin D levels checked regularly. If you are deficient, supplement as directed by your healthcare provider. Focus on iron-rich foods (meat, fish, legumes) and vitamin D sources (sunlight, fortified foods, or supplements if needed).

The menopausal transition is associated with a reduction in lean or muscle mass, with postmenopausal women showing approximately 5.7% lower muscle mass compared to premenopausal women, although this correlation may be confounded by aging and measurement limitations of DXA.

If you are going through menopause, expect a potential decline in muscle mass, particularly during the perimenopausal transition. This is not necessarily inevitable or irreversible. Focus on resistance training and adequate protein intake during this window, as it is a critical period where interventions may be most effective in preventing sarcopenia.