Browse the evidence

Obesity is a chronic disease driven by hypothalamic dysregulation of body fat mass set points, not by individual neglect of eating habits or exercise.

Stop blaming yourself for your weight. Your body is biologically defending a higher fat mass set point due to hypothalamic dysregulation. This is a chronic disease, not a moral failing. Effective treatment requires addressing this biology (e.g., via medications or surgery that target these pathways) rather than relying solely on willpower or calorie counting, which often fail because they trigger metabolic adaptation.

Metabolic and bariatric surgery (MBS) is the most effective treatment for obesity and type 2 diabetes, producing superior long-term weight loss and remission rates compared to lifestyle or pharmacologic interventions.

If you have severe obesity or type 2 diabetes, consider metabolic surgery. It is the most effective treatment for long-term weight loss and diabetes remission, far surpassing lifestyle changes or medications alone.

SGLT2 inhibitors reduce the risk of heart failure hospitalization and cardiovascular death in patients with type 2 diabetes, regardless of baseline ejection fraction or diabetes status.

If you have Type 2 Diabetes and Heart Failure (or are at high risk), ask your doctor about SGLT2 inhibitors (like Jardiance or Farxiga). These drugs are proven to significantly reduce the risk of being hospitalized for heart failure and dying from cardiovascular causes, regardless of your heart's pumping ability. They are now considered a standard part of treatment for this condition.

Resmetirom is the first FDA-approved drug for treating noncirrhotic nonalcoholic steatohepatitis (NASH) with moderate to advanced liver fibrosis, demonstrating efficacy in resolving NASH without worsening fibrosis and improving fibrosis by at least one stage without worsening NASH.

Resmetirom is now the first approved medication for NASH with fibrosis. It works by targeting thyroid hormone receptors to reduce liver fat and inflammation. Patients should discuss eligibility, specifically regarding fibrosis stage, with their healthcare provider, keeping in mind the high cost and the need for ongoing monitoring.

SGLT2 inhibitors significantly reduce the risk of hospitalization for heart failure and cardiovascular death in patients with type 2 diabetes, regardless of baseline glycemic control or heart failure status.

If you have Type 2 Diabetes and Heart Failure (or high risk for it), ask your doctor about SGLT2 inhibitors (like Jardiance or Farxiga). These drugs have strong evidence for reducing hospitalizations for heart failure and cardiovascular death, independent of their blood sugar-lowering effects. They are now a standard part of heart failure treatment guidelines.

Thiazolidinediones (TZDs) increase the risk of hospitalization for heart failure through fluid retention mediated by sodium reabsorption.

If you have Type 2 Diabetes and Heart Failure, especially if it is moderate to severe (NYHA class III or IV), you should likely avoid Thiazolidinediones (like Actos or Avandia). These drugs cause fluid retention and significantly increase the risk of being hospitalized for heart failure. Your doctor will likely choose a different medication.

The lack of a unified, consensus definition for sarcopenia hinders the development of evidence-based treatments and prevents accurate comparison of research outcomes.

Patients and doctors should be aware that inconsistent definitions of sarcopenia currently make it difficult to compare treatment results. However, resistance training remains the recommended standard of care regardless of the specific diagnostic label used.

Females exhibit higher GLP-1 receptor (GLP1R) expression in specific brain regions (PBN, AP/NTS) involved in processing aversive stimuli, which may explain their heightened sensitivity to GLP-1 agonist-induced nausea.

This finding suggests that women's brains may have more 'targets' for GLP-1 drugs in areas that control nausea, which is why side effects are more common. This is a biological fact, not a personal failing.

SGLT2 inhibitors (canagliflozin, dapagliflozin, empagliflozin) significantly slow the progression of diabetic kidney disease (DKD) and reduce cardiovascular events in patients with chronic kidney disease (CKD), regardless of baseline glycemic control or diabetes status.

If you have diabetes and kidney disease (or high cardiovascular risk), ask your doctor about SGLT2 inhibitors (like Jardiance, Farxiga, or Trjendi). These drugs protect your kidneys and heart, even if your blood sugar is already well-controlled. They are taken once daily. Be aware of potential genital yeast infections or, rarely, ketoacidosis, but these risks are generally manageable and outweighed by the protection they offer to your kidneys.

Bariatric surgery remains the most effective long-term treatment for severe obesity, offering superior durability and comorbidity remission compared to pharmacotherapy.

For severe obesity, surgery is still the most durable and effective option for long-term health improvement. It offers better comorbidity remission than drugs alone. Consider it if your BMI is very high or you have serious health issues.

Sibutramine, a serotonin-norepinephrine reuptake inhibitor, was withdrawn from the European market because it significantly increases the risk of serious cardiovascular events (stroke, heart attack, cardiac arrest) without providing sufficient long-term benefit.

Sibutramine is no longer available in Europe because it was found to increase the risk of heart attacks and strokes. If you encounter it in illicit products imported from outside the EU, be aware that these products may be unsafe and unregulated. Always inform your doctor about any weight loss supplements you are taking.

GLP-1 receptor agonists induce nausea and vomiting primarily by binding to GLP-1 receptors in the dorsal vagal complex (brainstem) and stimulating peripheral vagal nerve fibers, leading to delayed gastric emptying and increased gut-to-brain signaling.

Nausea from GLP-1 medications is not a sign of toxicity or damage. It is a predictable side effect caused by how the drug interacts with your brain and gut nerves. This is why starting with a low dose helps your body adapt. The feeling is temporary and manageable, and it does not mean the medication is harming you.

SGLT2 inhibitors (empagliflozin, dapagliflozin, canagliflozin) significantly reduce the risk of hospitalization for heart failure in patients with type 2 diabetes, independent of glycemic control.

If you have Type 2 Diabetes and are at risk for heart failure, ask your doctor about SGLT2 inhibitors (like empagliflozin or dapagliflozin). These drugs have been proven in large studies to significantly lower the risk of hospitalization for heart failure, even independent of their blood sugar-lowering effects. This is a key preventive strategy for heart health in diabetes.

Finerenone, a non-steroidal mineralocorticoid receptor antagonist, reduces cardiovascular and renal risks in patients with type 2 diabetes and chronic kidney disease.

If you have type 2 diabetes and kidney disease, adding finerenone to your current treatment can significantly lower your risk of heart problems and kidney failure. It is designed to avoid the side effects of older medications in its class.

Historical obesity pharmacotherapies utilizing thyroid hormones, sympathomimetics, and serotonergic agents were withdrawn due to severe cardiovascular, psychiatric, or oncological toxicity, despite demonstrating weight loss efficacy.

Do not use historical weight loss drugs like thyroid hormones, amphetamines, or fenfluramine. They are dangerous and have been withdrawn from the market due to severe side effects like heart damage and death. Modern treatments focus on safer mechanisms like GLP-1 agonists.

Roux-en-Y Gastric Bypass (RYGB) and Sleeve Gastrectomy (SG) are highly effective surgical interventions for severe obesity, with RYGB showing slightly greater long-term weight loss.

Surgical options like RYGB and SG are highly effective for severe obesity, leading to 47-55% excess weight loss over seven years. RYGB tends to result in slightly greater weight loss than SG, but both improve quality of life. These are major surgeries requiring careful patient selection and postoperative management.

There is no head-to-head evidence to determine which drug class (THR-β vs Incretins) is superior for histological outcomes in MASH.

Both resmetirom and incretins work for MASH, but we don't know which is better for the liver itself because no study has compared them directly.

The study reported no substantial differences in the numbers of adverse events between the two groups.

Both dietary approaches appear to be safe with respect to adverse events.

GLP‐1RAs triggered more gastrointestinal adverse events than placebo, with no in‐between difference.

Clinicians should be aware of the gastrointestinal side effects associated with GLP-1RAs when prescribing these medications.

The prevalence of obesity among primary care patients increased from 39.2% in 2017 to 40.7% in 2019.

Healthcare providers should be aware of the rising obesity rates among their patients.

Aerobic exercise at 8 KKW did not induce weight change, and there was no significant change in any component of energy expenditure.

Lower intensity aerobic exercise may not be sufficient for weight loss or changes in energy expenditure.

No significant between-group differences were noted in any outcome measure.

Fasted and fed aerobic exercise yield similar results in body composition changes.

Nonalcoholic fatty liver disease (NAFLD) affects more than 25% of adults worldwide.

Healthcare providers should be aware of the high prevalence of NAFLD in adult populations.

The majority of patients with NAFLD are unaware of their condition.

Awareness and screening for NAFLD should be prioritized in clinical practice.