Browse the evidence

GLP-1 agonists are likely unaffordable for universal healthcare systems due to high prevalence of OSA and high drug costs, potentially exacerbating healthcare inequities.

Be aware that GLP-1 agonists are expensive and may not be covered by public health insurance for OSA, creating a barrier to access for lower-income patients.

Bariatric surgery, specifically Roux-en-Y gastric bypass (RYGB), improves metabolic health partly by activating the endocannabinoid system (CB-1) to increase sympathetic nerve activity and promote white adipose tissue browning.

If you are considering bariatric surgery, understand that it works by changing how your body signals hunger and burns energy, not just by restricting food intake. Discuss all options with your healthcare provider.

There is insufficient evidence to support a causal relationship between GLP-1 receptor agonists and the risk of other common mental illnesses, including ADHD, Anorexia Nervosa, Autism Spectrum Disorder, and PTSD.

Based on this genetic study, GLP-1 drugs do not appear to reduce the risk of ADHD, Anorexia, Autism, or PTSD. Patients with these conditions should not rely on GLP-1 medications as a treatment for their mental health symptoms. Further research is needed to confirm these negative findings.

Current clinical practice for prescribing semaglutide for weight loss lacks comprehensive pretreatment screening for thyroid, pancreatic, and retinal risks, exposing patients to severe adverse outcomes.

If you are starting semaglutide for weight loss, ensure your doctor checks your calcitonin, pancreatic enzymes (lipase/amylase), and family history of thyroid cancer before starting. Standard blood tests are not enough to rule out serious risks associated with this medication.

Biomechanically calculated repair (BCR) using GRIP/CRIP concepts significantly reduces hernia recurrence rates compared to conventional repair techniques.

For complex hernias, ask if your surgeon uses biomechanical planning (GRIP/CRIP). This method tests how your abdominal wall handles daily stress before surgery, leading to a repair that is much less likely to fail (recurrence) compared to standard techniques. It may require a specialized center, but the long-term success rate is significantly higher.

Botulinum toxin A (BTA) injections and Progressive Preoperative Pneumoperitoneum (PPP) are effective mechanical optimization strategies for loss-of-domain hernias, reducing fascial tension and enabling primary closure.

If you have a very large hernia where the organs have slipped out of the abdominal cavity for a long time, standard surgery might be too risky. Your surgeon might recommend Botox injections to relax your abdominal muscles or a process called PPP (pumping air into your abdomen) to stretch your muscles before surgery. This makes it possible to close the hernia without major cutting, reducing recovery time and complications.

High-salt diets can enhance antitumor immunity in melanoma and lung cancer by promoting the differentiation of M1-like macrophages and increasing the infiltration and function of CD8+ T cells.

For patients with melanoma or lung cancer, high-salt intake might boost immune response, but this is a complex trade-off. Do not increase salt intake without consulting your oncologist, as it may not be suitable for everyone, especially those with heart conditions.

For individuals with obesity who fail to lose ≥2% body weight in the first 4 weeks of intensive behavioral treatment, adding phentermine (15.0 mg/day) significantly increases 24-week weight loss compared to continuing behavioral treatment with placebo.

If you have been doing intensive lifestyle changes for a month and haven't lost at least 2% of your body weight, adding phentermine (15 mg daily) to your plan can significantly boost your weight loss results compared to sticking with lifestyle changes alone. This approach helps early non-responders achieve clinically meaningful weight loss (≥5%) much more effectively. Regular monitoring of blood pressure and heart rate is recommended due to potential side effects.

Subcutaneous semaglutide (2.0 mg or higher, once weekly) produces significant weight loss and cardiometabolic improvements in adults with overweight or obesity, with efficacy increasing in patients with Class II obesity and higher dosages.

If you have overweight or obesity, subcutaneous semaglutide taken once weekly at a dose of 2.0 mg or higher is a highly effective treatment for weight loss. It works best when combined with lifestyle changes (diet and exercise). You can expect significant weight loss (nearly 9 kg on average in this analysis) and improvements in waist circumference and BMI. Patients with more severe obesity (Class II) tend to lose more weight. While gastrointestinal side effects like nausea are common, serious side effects are rare. The once-weekly schedule is preferred for adherence and safety over daily dosing.

AMG 133 (maridebart cafraglutide), a bispecific molecule combining a GIP receptor antagonist with a GLP-1 receptor agonist, produces pronounced, dose-dependent weight loss and improves metabolic parameters in adults with obesity.

AMG 133 is a new injectable medication for obesity that works by targeting two gut hormones (GLP-1 and GIP). In early clinical trials, it caused significant weight loss (up to 14.5% of body weight) with a dosing schedule of just one injection every four weeks. While it can cause temporary nausea or vomiting, these side effects are usually mild and go away quickly. It is currently in clinical trials and not yet widely available.

High-intensity interval training (HIIT) significantly improves insulin sensitivity (fasting insulin and HOMA-IR) and cardiorespiratory fitness (VO2max) compared to moderate-intensity continuous training (MICT) in patients with diabesity.

If you have type 2 diabetes and are overweight, High-Intensity Interval Training (HIIT) may offer better improvements in insulin sensitivity and heart health than steady-state moderate exercise. HIIT involves short bursts of effort exceeding 80% of your max heart rate. It is time-efficient and can be adapted to your fitness level, making it a viable option even if you have physical limitations.

HIIT and MICT produce comparable changes in body composition, lipid profiles, fasting blood glucose, HbA1c, and blood pressure in patients with diabesity.

For weight loss, blood sugar control (HbA1c), and blood pressure, both HIIT and moderate steady-state exercise appear to work equally well for people with diabesity. You do not need to do HIIT to see improvements in these specific areas; moderate exercise is sufficient.

In patients with diabesity who have comorbidities, HIIT may significantly increase HDL cholesterol and further reduce HOMA-IR compared to MICT.

If you have type 2 diabetes, obesity, and other health conditions, HIIT might offer extra benefits for your 'good' cholesterol (HDL) and insulin resistance compared to moderate exercise. However, the evidence for this is very low certainty.

Among GLP-1 receptor agonists, Tirzepatide demonstrates superior weight loss efficacy compared to Semaglutide and Liraglutide in post-bariatric surgery patients, with the lowest rate of non-responders.

If you are using a GLP-1 agonist after bariatric surgery and not seeing enough results, ask your doctor about switching to or starting Tirzepatide. It is a newer dual-agonist that has shown greater weight loss and fewer non-responders compared to older options like Liraglutide or Semaglutide in recent studies. Note that data is currently limited to shorter-term studies.

High-intensity interval training (HIIT) significantly improves cardiometabolic health markers—including glycemic control, insulin resistance, and lipid profiles—in patients with diabesity (Type 2 Diabetes and Obesity), even when body composition changes are minimal.

If you have Type 2 Diabetes and are overweight, High-Intensity Interval Training (HIIT) is a highly effective way to improve your blood sugar and cholesterol levels, even if the scale doesn't move much. Aim for short, intense bursts of exercise (like cycling or walking) 3 times a week for about 20-30 minutes, interspersed with rest. This approach targets your metabolic health directly and is considered safe for this population when prescribed correctly.

HIIT significantly improves lipid profiles (LDL, Triglycerides, Total Cholesterol) and insulin resistance (HOMA-IR) in patients with diabesity.

Focus on improving your insulin sensitivity and cholesterol through HIIT. This type of training has been shown to significantly lower your HOMA-IR score and improve LDL and Triglyceride levels compared to doing nothing, offering a powerful metabolic boost for those with diabesity.

Once-daily oral orforglipron significantly reduces body weight, BMI, and waist circumference compared to placebo in adult patients with obesity or overweight.

Take once-daily oral orforglipron as prescribed. Expect an average weight loss of about 6 kg compared to placebo, along with improvements in waist circumference and metabolic markers. Be prepared for common, non-severe gastrointestinal side effects like nausea, but note that serious adverse events are not increased. This is a viable alternative to injectable GLP-1s for those who prefer oral medication.

Protein supplementation combined with strength and conditioning training significantly increases muscular strength in athletes, whereas HMB, creatine, and vitamin D do not.

If your goal is to get stronger, ensure you are consuming enough protein alongside your strength training. This paper suggests protein is the most effective supplement for this outcome, while creatine, HMB, and vitamin D did not show significant strength benefits in this specific analysis of trained athletes.

Early interactive human health coaching via a mobile application improves dietary adaptation and quality of life (specifically reducing eating restriction) in patients who underwent gastrectomy for gastric cancer compared to conventional face-to-face counseling.

If you have had stomach cancer surgery, using a dedicated health app with a real dietitian for 3 months after discharge may help you adjust to eating smaller, more frequent meals with less trial and error than standard hospital visits alone. Ensure you have a smartphone or a caregiver to help you log your food and weight daily.

A 3-month pre-contest energy-restricted diet combined with an 8-week resistance training taper results in significant body mass loss (10.3%) but preserves or transiently increases maximal strength (isometric knee extension) prior to competition.

If you are cutting weight for a competition, expect your strength to fluctuate. In this case, strength peaked early in the cut and declined as the event approached, but returned to baseline after the event. Focus on maintaining protein intake (1.9-2.2 g/kg) and using a taper (reducing volume) in the final 10 days to manage fatigue while preserving strength.

Postoperative use of GLP-1 receptor agonists (specifically liraglutide and semaglutide) effectively treats suboptimal clinical response (SoCR) and recurrent weight gain (RWG) after metabolic bariatric surgery, achieving weight loss comparable to or exceeding non-surgical populations.

If you regain weight after bariatric surgery, do not assume you must have another operation. GLP-1 medications (like semaglutide or liraglutide) are highly effective at reversing weight regain and improving metabolic health, often working better than in non-surgical patients.

Increasing the intake of low- and no-calorie sweetened beverages (LNCSB) without substitution (i.e., adding them to the diet) is associated with lower body weight and waist circumference, but shows no significant association with type 2 diabetes risk.

Simply drinking more diet soda than you used to, without cutting out sugary drinks, might lead to a very small amount of weight loss over time. However, this increase in intake does not appear to lower your risk of developing type 2 diabetes.

Extending the dosing interval of GLP-1 receptor agonists (e.g., semaglutide, tirzepatide) from once-weekly to once-every-two-weeks reduces medication costs by approximately 50% while maintaining 70-75% of the weight loss efficacy.

If you are on a GLP-1 medication like semaglutide or tirzepatide and cost is a major barrier, discuss with your doctor the possibility of extending your dosing interval (e.g., from once a week to once every two weeks). While you might not lose as much weight as the maximum possible, you will likely retain most of the benefit (around 75%) while cutting your medication costs in half. This is particularly useful for ensuring long-term access to the medication.

Interactive nutrition education combined with behavior change techniques (e.g., goal setting) improves dietary intake and reduces nutritional risk in community-dwelling older adults.

For older adults looking to improve their diet, joining a group-based nutrition program that includes interactive education and goal setting is a promising strategy. While the evidence quality is low, the approach addresses common barriers like isolation and lack of knowledge. Look for community programs that emphasize interaction and practical behavior change techniques rather than just passive lectures.