Browse the evidence

Female patients report greater benefits from GLP-1RA treatment compared to male patients, particularly in mental well-being and physical functioning.

Be aware that female patients may report greater improvements in quality of life and mental well-being from GLP-1RAs than male patients. This is a documented trend in patient experiences.

GLP-1RAs improve the management of sweet cravings and reduce emotional eating.

GLP-1RAs can help reduce sweet cravings and emotional eating, making it easier to maintain weight loss. This is a reported benefit by patients.

Acute exercise triggers the release of 'exerkines' (such as IL-6, BNP, and FGF21) from various tissues, which act as systemic signals to coordinate energy mobilization, metabolic adaptation, and cross-tissue communication.

Understand that your muscles and organs 'talk' to each other during exercise through chemical signals called exerkines. This is why exercise benefits not just the muscles working, but also your heart, brain, and metabolism. Consistent exercise ensures these beneficial signals are regularly released.

NuSH therapies induce significant weight loss that often includes loss of lean mass and skeletal muscle, creating a risk for sarcopenic obesity if body composition is not monitored.

Monitor your body composition, not just your weight. If you are on NuSHs, ensure your treatment plan includes resistance training and protein optimization to preserve muscle mass, as weight loss alone may hide muscle loss.

The semaglutide 2.4 mg single-dose pen-injector (SPI) demonstrates high ease-of-use and acceptability, with the vast majority of participants finding it easy to use and training, and preferring it over daily oral medication.

If you are considering semaglutide 2.4 mg via the single-dose pen, expect it to be easy to use. Most users found the training simple and the injection process easy. While some initial use errors (like seeing liquid on the skin) can occur, they are common in the first few injections and tend to disappear with practice. The device is generally preferred over daily pills due to its weekly frequency and ease of use.

Morbid obesity (BMI ≥40 kg/m2) in young adults (16-49 years) is associated with a massive loss of future life years (8.3 years) and high mortality risk, with 72% of deaths in this demographic linked to obesity.

For young adults with morbid obesity (BMI ≥40), the health risks are severe and immediate in terms of life expectancy. This group loses an average of 8.3 years of life, with 72% of deaths linked to obesity. Early intervention is critical to prevent premature mortality.

GLP-1 agonists (e.g., semaglutide, liraglutide) and metformin can aid in weight management, but GLP-1 agonists do not reset the weight set point, leading to significant weight regain upon discontinuation.

GLP-1 agonists and metformin can help with weight loss, but they do not cure the underlying biological tendency to regain weight. If you use them, expect to use them long-term to maintain results. They are tools to manage weight, not a one-time fix.

BCAA supplementation significantly increases strength gains (specifically bench press and squat 1RM) in men undergoing resistance training, with greater magnitude than in women.

If you are a male recreational weightlifter, adding a BCAA supplement (2.5g Leucine, 1.25g Isoleucine, 1.25g Valine daily) to your 4-day/week resistance training program may help you lift more weight, particularly in the bench press and squat, compared to training without it. This benefit appears stronger in men than in women.

Lorcaserin extended release (XR) 20 mg once daily is bioequivalent to lorcaserin immediate release (IR) 10 mg twice daily in terms of total exposure (AUC), offering a convenience advantage with potentially lower peak concentrations (Cmax).

If you are prescribed lorcaserin XR, take 20 mg once a day, with or without food. This formulation is designed to provide the same total amount of medication as the older twice-daily version but with a lower peak concentration, which may reduce side effects like headaches. Consistency is key; take it at the same time each day.

Lorcaserin IR and XR promote weight loss and improve glycemic control in overweight or obese patients with type 2 diabetes when used as an adjunct to lifestyle modifications.

If you have type 2 diabetes and are overweight, lorcaserin (10 mg once or twice daily) can help you lose weight and lower your HbA1c. It works best when combined with diet and exercise. Common side effects like headaches are usually mild.

In healthy young humans, changes in skeletal muscle mass in response to resistance exercise, disuse, and aging are primarily driven by alterations in muscle protein synthesis (MPS), while muscle protein breakdown (MPB) remains largely unchanged or plays a negligible role.

To maintain or build muscle, prioritize resistance exercise and protein intake to stimulate muscle protein synthesis. You do not need to worry about 'blocking' muscle breakdown as a primary strategy, as your body naturally regulates this, and forcing suppression may be counterproductive. Consistent loading is the key lever.

Deuterated water (D2O) ingestion is a valid and increasingly used method for measuring long-term muscle protein synthesis in humans, providing insights that complement acute tracer infusion methods.

For researchers, D2O is a reliable tool for measuring long-term muscle protein synthesis. For practitioners, this validates that consistent, long-term training and nutrition strategies are what drive muscle changes, rather than just acute post-workout spikes.

In aging skeletal muscle, the progressive loss of mass (sarcopenia) is largely driven by anabolic resistance—a desensitized muscle protein synthesis response to stimuli like loading and protein ingestion—rather than increased protein breakdown.

Older adults should prioritize resistance training and adequate protein intake to overcome anabolic resistance. While muscle loss is slower with age, maintaining activity levels can prevent many age-related muscle deficits.

Patients with specific comorbidities, specifically dyslipidaemia and obstructive sleep apnoea (OSA), have significantly higher odds of receiving both anti-obesity medication (AOM) prescriptions and metabolic and bariatric surgery (MBS).

Having comorbidities like high cholesterol or sleep apnea can increase your chances of being prescribed obesity treatments. If you don't have these, you may face more hurdles. Discuss your overall metabolic health with your provider, as obesity itself is a valid reason for treatment.

GLP-1 receptor agonists significantly reduce binge eating behaviors and alcohol consumption, offering therapeutic potential for substance use disorders and eating disorders independent of weight loss.

If you struggle with binge eating or alcohol use, GLP-1 medications might help reduce these cravings directly, not just by making you lose weight. Clinical trials show significant improvements in binge eating scores and reduced alcohol intake. This suggests the drug affects the brain's reward system, offering a new tool for managing these specific behaviors.

In drug-naive patients with prediabetes, initiating GLP-1 RA as first-line therapy significantly reduces the 1-year risk of requiring additional glucose-lowering medication compared to metformin, but is associated with a significantly higher risk of treatment nonadherence.

For patients with prediabetes, GLP-1 RA is more effective than metformin at preventing the need for extra diabetes medications over one year. However, patients are more likely to stop taking GLP-1 RA than metformin. Clinicians should proactively manage expectations regarding side effects and adherence to maximize the benefit.

In drug-naive patients with diabetes, initiating GLP-1 RA as first-line therapy reduces the 1-year risk of requiring additional glucose-lowering medication compared to metformin, with no significant difference in adherence rates.

For patients with diabetes, GLP-1 RA is more effective than metformin at preventing the need for extra diabetes medications over one year, with similar adherence rates. This makes GLP-1 RA a strong first-line option for diabetes management.

Self-reported dietary intake methods (Remote Food Photography Method) significantly underestimate energy intake compared to doubly labelled water (DLW) derived estimates, leading to an overestimation of the prevalence of Low Energy Availability (LEA) in female soccer players.

If you are a female soccer player or coach using food photography or logs to track energy availability, be aware that you are likely under-reporting intake by about 22%. This means you might think you have Low Energy Availability (a risk factor for injury and hormonal issues) when you actually don't. Do not make drastic dietary changes based solely on self-reported data without considering this potential under-reporting bias.

Supplementing with 20g of native whey protein twice daily during a 12-week strength training program yields equivalent gains in muscle mass and strength compared to supplementing with an equivalent dose of spray-dried milk.

If you are starting a strength training program, you do not need to buy expensive native whey protein. Drinking milk or consuming standard milk powder provides the same muscle-building benefits as native whey, provided you are consuming enough total protein (around 1.6-2.0 g/kg/day) and training consistently.

Increasing cardiorespiratory fitness and losing body mass index (BMI) independently and synergistically slow the progression of deficit accumulation frailty (a marker of biological aging) in adults with type 2 diabetes and overweight/obesity.

If you have type 2 diabetes and are overweight, focusing on improving your aerobic fitness (like brisk walking for >175 minutes a week) and losing weight (targeting >7% loss) can significantly slow biological aging. These two actions work independently: improving fitness helps even if you don't lose much weight, and losing weight helps even if your fitness doesn't change much. Doing both provides the greatest benefit. This applies even if you are over 65.

Long-term adherence to healthy low-carbohydrate or low-fat diets results in transient microbiota shifts that revert toward baseline composition, demonstrating microbiome resilience despite sustained weight loss.

If you are trying to lose weight and keep it off, know that your gut bacteria will likely bounce back to their original state after the first few months, even if you stick to your diet. This 'resilience' might make long-term weight maintenance harder. Focus on sustainable dietary habits rather than expecting your microbiome to permanently change to support weight loss.

Long-term pharmacotherapy for obesity requires medications with proven efficacy and safety, as lifestyle modification alone is often insufficient for sustained weight loss.

If lifestyle changes alone aren't enough, consult a doctor about long-term obesity medications. These drugs are designed for sustained use and can help manage weight effectively, but they come with side effects and costs that need to be managed.

Older anti-obesity medications (Orlistat, Naltrexone/Bupropion, Phentermine/Topiramate, Liraglutide) have limited efficacy compared to newer GLP-1/GIP agonists.

Older obesity medications provide moderate weight loss (8-10%). They are established options but are less effective than the newest injectable treatments.

Tirzepatide treatment (5-15 mg weekly for 72 weeks) significantly improves both insulin sensitivity and beta-cell function in adults with obesity or overweight (BMI ≥27 kg/m2) with prediabetes or normoglycemia, independent of type 2 diabetes.

If you have obesity or are overweight and have prediabetes or normal blood sugar, tirzepatide (a once-weekly injection) can significantly improve how your body handles insulin and how well your pancreas functions. This happens partly because you lose weight, but also directly from the medication itself, potentially lowering your risk of developing type 2 diabetes.