Browse the evidence

Digital Cognitive Behavioral Therapy (CBT) delivered via a mobile platform with daily psychologist feedback and assignments significantly improves weight loss and weight maintenance compared to self-directed digital tools in young adults with obesity.

If you are between 18 and 39 with a BMI between 25 and 40, using a digital CBT app with daily psychologist feedback and assignments for 8 weeks is a viable strategy for weight loss. This approach is more effective than using digital tools for self-care (like food diaries) alone. Ensure you have a smartphone and are motivated to use it.

Losing 5% or more of body weight within the first year following a type 2 diabetes diagnosis significantly reduces the 10-year risk of cardiovascular disease events compared to maintaining weight.

If you were recently diagnosed with type 2 diabetes, aim to lose at least 5% of your body weight in the first year. This moderate loss is linked to a significantly lower risk of heart disease and stroke over the next decade. You don't need extreme measures; focusing on small, sustainable changes to your diet and activity levels can yield major long-term heart benefits.

Ultra-processed foods cause increased energy intake and weight gain even when matched for macronutrients and energy content, compared to unprocessed foods.

Avoid ultra-processed foods. Even if they have the same calories and macros as whole foods, you will likely eat more and gain weight. Focus on whole, unprocessed foods to naturally regulate intake.

Acute ingestion of 3 mg/kg caffeine significantly improves resistance exercise performance (velocity, power, repetitions), jumping height, and sprinting power in resistance-trained men, regardless of CYP1A2 genotype (AA vs. AC/CC).

Take 3 mg of caffeine per kg of body weight about an hour before your workout. This will likely improve your speed, power, and number of reps in resistance training, jumping, and sprinting. You do not need to worry about your CYP1A2 genotype (fast vs. slow metabolizer) as this dose works for everyone. Stick to this moderate dose; you don't need extreme amounts to see benefits.

Lower load resistance training (loads < 50% 1RM) induces similar or superior muscle hypertrophy and strength adaptations compared to traditional higher load training (loads > 70% 1RM), provided the lower load sets are performed in close proximity to concentric failure.

To build muscle and strength without heavy weights, use loads between 30-50% of your one-rep max. Perform 2-3 sets of 3-4 exercises, 2-3 times a week. The key is effort: you must perform reps until you can barely complete another one (concentric failure) or are within 3-5 reps of that point. This approach is as effective as heavy lifting for most people and is easier on your joints.

Lower load resistance training (30-50% 1RM) improves metabolic health markers, including glycemic control and cardiovascular risk factors, comparable to or better than higher load training when volume is matched.

If you have diabetes or heart concerns, you can still benefit from resistance training using lighter weights (30-50% 1RM). Ensure you match the total volume (sets x reps) of heavier training. This approach improves blood sugar control and cardiovascular risk without the dangerous blood pressure spikes seen with heavy lifting.

Triple incretin agonists (GLP-1R/GIPR/GCGR) produce superior body weight reduction (up to 24.2%) compared to dual or mono-agonists, approaching the efficacy of bariatric surgery.

Retatrutide, a once-weekly injection targeting three gut hormone receptors, has shown remarkable weight loss results (up to 24% in trials). While side effects like nausea are common, they are often manageable by starting with a lower dose. This therapy represents a significant advancement over older GLP-1 drugs, offering efficacy closer to bariatric surgery without the surgical risks.

GLP-1/Glucagon dual agonists (e.g., mazdutide, survodutide) produce greater weight loss and triglyceride reduction compared to GLP-1 mono-agonists.

Dual agonists targeting GLP-1 and Glucagon receptors (like survodutide) have shown significant weight loss (up to 18.7%) and improved triglyceride levels in Phase 2 trials. These drugs leverage the fat-burning and energy-expenditure effects of glucagon while maintaining glucose control through GLP-1.

SGLT-2 inhibitors reduce body weight and visceral adiposity in Asian patients with type 2 diabetes, making them a preferred therapeutic option for overweight or obese patients.

If you have Type 2 Diabetes and are overweight, ask your doctor about SGLT-2 inhibitors (like Jardiance, Farxiga, or Invokana). Unlike older diabetes meds that often cause weight gain, these drugs help you lose weight and reduce belly fat while managing your blood sugar.

Higher-quality protein sources (e.g., whey, milk) produce a significantly greater acute muscle protein synthesis (MPS) response than lower-quality sources (e.g., soy, wheat, casein) when matched for dose, both at rest and following resistance exercise.

If you are trying to maximize muscle growth, prioritize high-quality protein sources like whey, milk, eggs, or meat over lower-quality plant proteins (like wheat or soy) when possible. This is especially relevant for older adults who may experience 'anabolic resistance.' However, this is a small effect; hitting your total daily protein target is still the most important factor.

Resistance training to failure causes significant strength decrements (7-11%) 24 hours post-exercise, whereas training to non-failure (2 reps in reserve) preserves strength performance.

If you train to failure, expect your strength to drop by 7-11% the next day. If you want to maintain strength or train more frequently, stop 2 reps before failure. This doesn't mean failure training is 'bad', but it costs you more recovery time.

Performing resistance exercise once per week (Weekend Warrior) or using single-set protocols significantly increases muscle strength in untrained individuals compared to no exercise, despite volumes being lower than standard guidelines.

If you are not currently exercising, start with just one session per week or do single sets of exercises. You do not need to follow complex multi-set routines to get stronger. Consistency with a minimal dose is better than no exercise at all.

GLP-1 receptor agonists (e.g., liraglutide) produce significant weight loss (mean 8.4 kg over 56 weeks) by slowing gastric emptying and activating central satiety pathways, with 33.1% of patients achieving >10% body weight loss.

If you have obesity (BMI > 30, or > 27 with health issues), ask your doctor about GLP-1 agonists like liraglutide. This medication, taken daily, has been shown in clinical trials to help patients lose an average of 8.4 kg over a year, with many losing over 10% of their body weight. It works by slowing digestion and signaling fullness to your brain.

Bariatric surgery leads to greater long-term weight loss and better glycemic control (lower HbA1c, HOMA-IR) compared to conventional medical therapy in severely obese T2DM patients, with specific surgical types (RYGB, BPD) showing superior metabolic effects.

Bariatric surgery provides superior long-term weight loss and blood sugar control compared to medication alone for severely obese diabetics. The specific type of surgery (e.g., RYGB vs. BPD) influences which metabolic markers improve most, so discussing these differences with a healthcare provider is important for personalized treatment.

A 6-month technology-assisted lifestyle intervention (eCMP) comprising virtual stress management, behavioral diet counseling, and in-person physical activity sessions significantly reduces body weight and waist circumference in high-risk adults with cardiometabolic risk factors.

If you are at high risk for heart disease or diabetes, a structured 6-month program using video calls, online resources, and in-person exercise sessions can help you lose weight and reduce your waist size. The key is consistency: attending about half of the virtual sessions and some of the in-person exercise classes. You will need internet access and a willingness to use basic technology like a fitness tracker and online portal.

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) promote weight loss in obese individuals with type 2 diabetes, whereas sulfonylureas, thiazolidinediones, and insulin typically cause weight gain.

If you have type 2 diabetes and are obese, ask your doctor about SGLT2 inhibitors (like Jardiance/Farxiga) or GLP-1 agonists (like Ozempic/Victoza). These drugs lower blood sugar and typically help you lose 2-3 kg, whereas older drugs like insulin or sulfonylureas often make you gain weight. Combining these with metformin can enhance weight loss.

Combining SGLT2 inhibitors with GLP-1 receptor agonists results in greater weight loss and HbA1c reduction than using either drug alone.

If one medication isn't enough to control your blood sugar and weight, ask about combining an SGLT2 inhibitor with a GLP-1 agonist. Studies show this combo leads to more weight loss (around 3.4 kg in trials) and better blood sugar control than using either drug alone.

Protein restriction (0.6-0.8 g/kg/day) is recommended for T2DM patients with chronic kidney disease (CKD) to slow progression.

If you have kidney issues, limit protein to 0.6-0.8g per kg of body weight daily. Focus on high-quality vegetable proteins. This helps protect your kidneys from further damage.

Increasing daily protein intake to 1.0–1.5 g/kg/day in older adults improves glycemic control and preserves muscle mass, counteracting age-related sarcopenia and insulin resistance.

If you are over 40 and concerned about diabetes or muscle loss, aim for 1.0 to 1.5 grams of protein per kilogram of body weight every day. This is higher than the standard recommendation and helps protect your muscles while improving how your body handles sugar. Focus on high-quality sources like dairy or whey, and combine this with resistance exercise for the best results.

Dairy-based proteins, particularly whey, improve insulin sensitivity and muscle protein synthesis more effectively than other protein sources due to their insulinotropic properties and leucine content.

Incorporate 2-4 servings of dairy or 20-84g of whey protein daily. Whey is particularly effective because it stimulates insulin release without spiking blood sugar, helping to manage glucose and build muscle. Yogurt with probiotics is also beneficial for gut health and insulin sensitivity.

Combining high protein intake with resistance exercise synergistically increases muscle mass and improves insulin sensitivity more than either intervention alone in older adults with T2D.

For the best results in managing diabetes and building muscle, combine resistance training (3 times a week) with a high-protein diet. This combination is more effective than diet or exercise alone, significantly reducing insulin levels and building muscle mass.

Structured training using the HMR Calorie System (memorizing anchor points for reference foods) significantly improves the accuracy of calorie and portion size estimation in overweight adults.

To improve your ability to estimate food intake, use a structured calorie counting system like the HMR method. This involves memorizing 'anchor points' (reference foods with known calorie counts) and using them to estimate similar foods. Training in this system for just 4 weeks significantly improves estimation accuracy. Focus on learning these reference points rather than trying to calculate every food from scratch.

Achieving 6-7 guideline-recommended risk factor targets (non-smoking, physical activity, healthy diet, BMI 20-25, BP <140/90, HbA1c <7%, total cholesterol <5.2 mmol/L) eliminates the excess mortality risk and life expectancy loss associated with Type 2 Diabetes compared to non-diabetic individuals.

If you have Type 2 Diabetes, do not accept reduced life expectancy as inevitable. Focus on achieving seven specific health targets: never smoke, stay physically active (150+ mins/week moderate activity), eat a healthy diet (fruits, veggies, whole grains, fish), maintain a BMI between 20-25, keep blood pressure under 140/90, keep HbA1c under 7%, and keep total cholesterol under 5.2 mmol/L. Achieving 6 or 7 of these targets can reduce your mortality risk to the same level as someone without diabetes.

Maintaining circulating 25-hydroxyvitamin D levels at or above 75 nmol/L is associated with significantly lower risks of falls and fractures in older adults, particularly when combined with adequate calcium intake.

Aim for a blood level of 25OHD at or above 75 nmol/L. For older adults, this often requires supplementation or significant sun exposure, as diet alone provides only 10-20% of status. Ensure you are also getting 1000-1200 mg of calcium daily, as Vitamin D works synergistically with calcium to protect bone density and reduce fall risk.