Browse the evidence

Bariatric surgery significantly reduces the incidence of specific obesity-related cancers, including hepatocellular, colorectal, pancreatic, gallbladder, breast, endometrial, and ovarian cancers.

Bariatric surgery offers significant protection against several specific types of cancer, particularly those linked to obesity and hormones (breast, endometrial, ovarian) and metabolic factors (liver, colorectal, pancreatic, gallbladder).

Produce prescription programs do not significantly change BMI z-score in children, despite improvements in fruit and vegetable intake and food security.

While produce prescription programs improve diet and food security for children, they may not immediately impact BMI z-score. Focus on the overall health benefits and improved access to nutritious food rather than expecting immediate changes in weight metrics.

Living in less walkable neighborhoods is associated with lower systolic blood pressure, higher HDL cholesterol, and lower likelihood of diabetes, but also lower likelihood of smoking.

While walkable areas might have higher smoking rates, the overall cardiovascular risk is still lower due to the benefits of daily physical activity. If you live in a walkable area, be aware of tobacco availability and consider cessation support. If you live in a less walkable area, prioritize active transport options to offset the higher CVD risk.

Brief adaptation (5-6 days) to a ketogenic low-carbohydrate high-fat (LCHF) diet impairs high-intensity endurance performance and increases the oxygen cost of exercise, even when muscle glycogen is acutely restored prior to competition.

If you are an endurance athlete, switching to a very low-carb, high-fat diet for even a few days can hurt your race performance, even if you eat a lot of carbs right before the event. Your body's ability to use carbs efficiently at high intensities takes longer than 24 hours to recover. Stick to high-carbohydrate availability for key workouts and races to maintain speed and efficiency.

Lifestyle interventions alone are often insufficient for long-term weight maintenance due to hormonal and metabolic adaptations that drive weight regain, necessitating adjunctive therapies for many patients.

If you regain weight after lifestyle changes, do not blame yourself. Your body's hormones and metabolism are adapting to store energy. This is a common biological response, and it is why medical guidelines recommend considering additional therapies (like medication) if lifestyle changes alone do not sustain your results.

Sulfonylureas are associated with weight gain, hypoglycemia, and declining long-term efficacy, making them unsuitable as first- or second-line treatments.

Avoid sulfonylureas if possible. They cause weight gain and low blood sugar, and their effectiveness fades over time. Use them only if other, safer options are not available or affordable.

Sustained weight loss (defined as >1 kg/year over 2 years) is an independent risk factor for higher all-cause and cardiovascular mortality in patients with diabetes/prediabetes and CV risk, compared to maintaining stable weight.

If you have diabetes and heart disease risks, do not try to lose weight. If you have lost weight, do not try to lose more. Your goal should be to stabilize your weight. Aggressive weight loss strategies may increase your risk of death.

Adipose tissue (AT) dysfunction, rather than fat mass alone, is the primary mechanistic link between obesity and adverse health outcomes, explaining why some individuals with obesity remain metabolically healthy while others with normal weight develop obesity-related diseases.

Your health risk from obesity is not just about how much you weigh, but how your fat tissue is functioning. Factors like visceral fat, inflammation, and insulin sensitivity matter more than BMI alone. Focus on metabolic health markers rather than just the scale.

Long-acting GLP-1 receptor agonists (liraglutide and semaglutide) activate POMC neurons and inhibit NPY/AgRP neurons in vivo, with effects occurring 12-24 hours post-injection and dependent on the TRPC5 channel and metabolic state.

Long-acting GLP-1 drugs like liraglutide and semaglutide change brain activity related to hunger and energy use, but this happens slowly, peaking 12-24 hours after injection. This effect is stronger when you are fasting. The drug works by activating specific brain cells (POMC) that reduce hunger and inhibiting others (NPY/AgRP) that increase it, using a channel called TRPC5.

Intermittent Energy Restriction (IER), including intermittent fasting and time-restricted eating, does not provide clear incremental benefit over Continuous Energy Restriction (CER) for weight loss or cardiometabolic health in humans.

Intermittent fasting or time-restricted eating is not superior to simply eating fewer calories every day for weight loss or heart health. If you prefer fasting, it may help you restrict calories, but it offers no extra metabolic benefit over consistent daily calorie control. Choose the approach that fits your lifestyle and allows you to maintain a healthy diet.

Intensive lifestyle intervention (ILI) increases the risk of frailty fractures and negatively impacts bone mineral density and lean body mass in adults with overweight/obesity and type 2 diabetes.

Be aware that significant weight loss can lead to some loss of bone density and a higher risk of fractures. Discuss strategies to protect your bones, such as ensuring adequate calcium/vitamin D intake and incorporating resistance training, with your healthcare provider while pursuing weight loss.

Household-level food expenditure and availability data (e.g., FAO Food Balance Sheets) are not reflective of individual dietary intakes and fail to capture intra-nation heterogeneity.

Do not rely on national food availability statistics to assess individual or subgroup dietary risks. These aggregate measures fail to capture individual consumption patterns and demographic disparities, leading to inaccurate health assessments.

Obesity is a neurobehavioral disorder resulting from the interaction of a 'vulnerable brain' (biological dysregulation of homeostatic and hedonic pathways) and an obesogenic food environment, rather than solely a failure of willpower.

If you struggle with obesity, understand that it is not just a lack of willpower. Your brain's biological signaling for hunger and satiety, combined with the modern food environment, creates a 'vulnerable brain' state. Effective management requires addressing both the biological signals (e.g., through medical or behavioral interventions) and the environment (e.g., reducing access to hyper-palatable foods).

Gut peptides such as GLP-1 and PYY, along with vagal afferent signaling, play a critical role in homeostatic appetite suppression and satiety signaling.

Your gut produces hormones like GLP-1 and PYY when you eat, which signal your brain to stop eating. This is a natural biological process. Understanding this can help explain why certain foods or eating patterns might affect your satiety levels.

Adipocyte ATP-citrate lyase (ACLY) is essential for handling dietary carbohydrates and maintaining metabolic homeostasis in females, as its deficiency leads to lipodystrophy-like phenotypes, hepatic steatosis, and insulin resistance when consuming high-carbohydrate diets.

For women, high-carbohydrate diets may pose a higher metabolic risk if adipose tissue function is compromised, potentially leading to fat storage in the liver and insulin resistance. Men may tolerate similar carbohydrate loads better. This suggests that women might benefit from monitoring carbohydrate quality and quantity more closely, especially if they have underlying metabolic vulnerabilities.

Brainstem cholecystokinin-expressing (CCKAP/NTS) neurons are required for the appetite-suppressing and body-weight-lowering effects of GLP-1 receptor agonists.

GLP-1 medications like semaglutide or liraglutide work by activating specific neurons in the brainstem (CCK neurons). If these neurons are blocked or non-functional, the medication will not suppress appetite or reduce body weight. This highlights that the drug's efficacy depends on this specific neural pathway.

GIP receptor activation reduces the recruitment of CCKAP/NTS neurons and selectively reduces conditioned taste avoidance without abolishing weight loss.

Adding GIP receptor activation to GLP-1 therapy reduces the activation of brainstem neurons responsible for nausea, thereby reducing side effects like nausea without significantly compromising the weight-loss benefits. This suggests dual-agonists may offer a better tolerability profile.

Higher intake of unprocessed red meat and total meat is associated with a significantly higher incidence of atherosclerotic cardiovascular disease (ASCVD) in older adults, partly mediated by gut microbiota-derived metabolites TMAO, gamma-butyrobetaine, and crotonobetaine.

If you are over 65, be mindful of your red meat consumption. This study links higher intake of unprocessed red meat and total meat to a higher risk of heart disease and stroke. The risk is partly explained by how gut bacteria process compounds in red meat into substances like TMAO. You don't need to eliminate red meat entirely, but balancing it with fish, poultry, and plant-based proteins may help lower your cardiovascular risk.

Intake of fish, poultry, and eggs is not significantly associated with incident atherosclerotic cardiovascular disease (ASCVD) in older adults.

You can likely continue to eat fish, poultry, and eggs without increasing your risk of heart disease or stroke, according to this study of older adults. These foods do not show the same negative association with cardiovascular health that red meat does. Focus on reducing red meat intake while maintaining these other protein sources.

There is no conclusive evidence that varying the relative quantities of dietary carbohydrates and fats (macronutrient partitioning) significantly affects the degree of weight loss or the duration of weight maintenance beyond the effects of total caloric intake.

Do not expect a specific macronutrient ratio (low-carb vs. low-fat) to give you a metabolic advantage for long-term weight loss if you are eating the same number of calories. The science shows that both diets work equally well for weight maintenance when calories are matched. Focus on finding a diet you can adhere to long-term, as compliance is the primary driver of success, not the specific ratio of carbs to fats.

Intensive lifestyle interventions (diet and exercise) alone do not significantly reduce cardiovascular event risk in overweight/obese adults with type 2 diabetes compared to usual care, whereas weight loss achieved through metabolic surgery significantly reduces complications and mortality.

While healthy eating and exercise are important, they might not be enough to protect your heart if you have type 2 diabetes and are overweight. The Look AHEAD study showed that intensive lifestyle changes didn't lower heart attack or stroke risk compared to standard care. However, losing a significant amount of weight (10% or more) did help. For some, metabolic surgery offers the best chance to reduce complications and live longer. Talk to your doctor about combining lifestyle changes with medications or other treatments.

Longitudinal changes in body composition (fat mass, lean mass, or waist circumference) are not significantly associated with the risk of myocardial infarction (MI) in patients with type 2 diabetes.

In type 2 diabetes, losing weight and fat does not significantly reduce your risk of having a heart attack (myocardial infarction). However, it does significantly reduce your risk of heart failure. Therefore, weight loss remains crucial for heart health, but for different reasons than preventing heart attacks.

A Mediterranean eating plan supplemented with either extra-virgin olive oil or mixed nuts does NOT significantly reduce the need for initiating insulin therapy in patients with type 2 diabetes compared to a low-fat control diet.

While a Mediterranean diet with olive oil or nuts can help delay starting oral diabetes medications, it may not prevent the need for insulin therapy in all patients. Do not rely on diet alone to avoid insulin if your doctor recommends it based on your blood sugar levels.

When inequalities in behavioral weight management interventions do exist, they tend to favor 'more advantaged' groups (e.g., older, higher SES, employed) in terms of trial uptake, intervention adherence, and trial attrition.

If you are from a 'less advantaged' background (e.g., lower income, rural, younger), you may face higher barriers to starting or sticking with a weight loss program. This is not a reflection of your ability but of the program's design requiring high personal agency. Seek programs that reduce these barriers.