Browse the evidence

Silibinin (150-300 mg) and thistle extract inhibit human pancreatic lipase in vivo, leading to increased fecal fat excretion and reduced waist circumference, with a significantly lower adverse effect profile compared to orlistat.

Taking 150-300 mg of silibinin or thistle extract with meals may help reduce abdominal fat by blocking some dietary fat absorption, with fewer gastrointestinal side effects than prescription fat-blockers like orlistat. However, this was observed in a very short-term study of healthy, normal-weight people, so long-term efficacy and safety for weight loss in obese individuals remain unproven.

Integrative Korean Medicine Treatment (IKMT), comprising personalized herbal medicine (including Ephedrae Herba) and dietitian-led lifestyle modification, produces statistically significant weight loss and blood pressure reductions in obese adults with a safety profile comparable to or better than GLP-1 receptor agonists.

This study suggests that a structured program combining personalized herbal medicine (specifically containing Ephedrae Herba) with professional dietary coaching can lead to significant weight loss (average ~8.7%, up to ~28% in best responders) and improved blood pressure. It serves as a viable alternative for individuals who cannot tolerate or afford GLP-1 medications, provided they undergo proper medical screening for contraindications like heart or liver disease.

GLP-1 receptor agonists (exenatide, liraglutide) are effective for weight loss in patients with schizophrenia who are gaining weight due to antipsychotic medications (clozapine/olanzapine).

For patients with schizophrenia taking clozapine or olanzapine who experience significant weight gain, GLP-1 agonists (exenatide or liraglutide) are a promising treatment option. They effectively reduce weight gain (avg 3.71 kg difference) without interacting with the antipsychotic medications, avoiding the need to change psychiatric treatment.

GLP-1 receptor agonists (Liraglutide, Semaglutide) are effective and safe for treating obesity in children and adolescents, with FDA approval for Liraglutide in this population.

For children and adolescents with obesity, Liraglutide is an FDA-approved option. It helps reduce weight (avg 2.74 kg in trials) and improves HbA1c. Side effects are generally mild GI symptoms or minor hypoglycemia. It should be used alongside diet and exercise.

Virtual delivery of a full meal replacement (FMR) intensive lifestyle intervention program yields weight loss outcomes statistically equivalent to in-person delivery.

If you are considering a meal replacement weight loss program, delivering it virtually (via video) is just as effective as doing it in person. In fact, virtual participants attended more sessions, which may contribute to the comparable weight loss results. You do not need to travel to a clinic to achieve significant weight loss with this protocol.

Pre-existing use of Glucagon-like Peptide-1 Receptor Agonists (GLP-1 RA) is significantly associated with reduced weight loss in patients undergoing a Full Meal Replacement (FMR) intensive lifestyle intervention.

If you are currently taking a GLP-1 RA (like Ozempic or Wegovy) and start a strict meal replacement program, you might not lose as much weight as expected compared to those not on the medication. This does not mean the medication is ineffective, but its interaction with the FMR protocol may differ from standard expectations. Discuss this with your provider.

GLP-1 receptor agonists (e.g., semaglutide, tirzepatide) reduce cancer risk in overweight/obese individuals primarily through sustained weight loss and secondarily through weight-loss-independent anti-inflammatory and metabolic mechanisms.

For individuals with obesity, GLP-1/GIP agonists (like semaglutide or tirzepatide) are more effective than diet alone for achieving sustained weight loss, which is linked to reduced cancer risk. These medications work by reducing hunger and improving metabolic health. While they require ongoing use and can be costly, they offer a clinically significant advantage over lifestyle changes alone for those who struggle with long-term adherence.

GLP-1 receptor agonists used for weight management are associated with nutritional deficiencies, specifically protein deficiency and metabolic acidosis, which may lead to malnutrition.

When using GLP-1 medications for weight loss, pay attention to your nutrition. Reports suggest a higher risk of protein deficiency and metabolic acidosis. Ensure you are eating enough protein and staying hydrated. If you feel unwell, dizzy, or experience unusual symptoms, talk to your doctor about your diet and medication.

Dual GLP-1/Glucagon agonists (e.g., mazdutide, cotadutide, efinopegdutide) show promise for treating non-alcoholic steatohepatitis (NASH) and obesity, though with higher rates of gastrointestinal side effects compared to GLP-1 monotherapy.

For patients with obesity and non-alcoholic steatohepatitis (NASH), dual GLP-1/Glucagon agonists may offer a unique benefit by promoting liver fat oxidation. However, these drugs may cause more gastrointestinal side effects than standard GLP-1 drugs, so the trade-off between liver benefits and tolerability should be discussed with a doctor.

Intragastric balloons (IGBs) and oral superabsorbent hydrogels (OSH) provide moderate weight loss (10-15% TBWL for IGBs, ~10% for OSH) by physically occupying stomach volume and triggering satiety signals, serving as minimally invasive alternatives for patients who are not surgical candidates.

If you are not a candidate for surgery or drugs, or want a temporary, non-surgical option, intragastric balloons or hydrogels can help. Balloons are placed in the stomach for 6-12 months to take up space and make you feel full, leading to 10-15% weight loss. Hydrogels are swallowed before meals and expand to trigger satiety. These are less effective than surgery or GLP-1 drugs long-term but offer a middle ground for those avoiding needles or surgery.

48 weeks of tirzepatide treatment significantly improves liver steatosis, liver enzymes, and surrogate markers of liver fibrosis in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) and type 2 diabetes mellitus (T2DM).

For patients with both fatty liver disease and type 2 diabetes, tirzepatide is a well-tolerated treatment that significantly reduces liver fat, improves liver enzyme levels, and slows down fibrosis markers over 48 weeks. While gastrointestinal side effects like nausea are common, they are typically mild and do not force most patients to stop the medication. The benefits extend beyond just weight loss, likely due to the specific dual-action mechanism of the drug on liver metabolism.

Lanifibranor (800-1200 mg daily) significantly improves MASH resolution and fibrosis regression in patients with noncirrhotic MASH compared to placebo.

Lanifibranor (800-1200mg daily) is a promising late-stage drug for MASH that targets multiple metabolic pathways. It significantly improves liver health scores compared to placebo, though monitor for mild weight gain and GI issues.

Saroglitazar (4 mg daily) significantly improves liver enzymes and liver fat content in patients with MASLD/MASH.

Saroglitazar (4mg daily) is approved in India for MASH. It significantly lowers liver enzymes and liver fat. It is currently in Phase 2b trials in the US and other regions.

Tirzepatide therapy significantly improves metabolic control (HbA1c, fasting glucose) and lipid profiles (LDL, HDL, triglycerides) in patients with heart failure.

If you have heart failure and are prescribed tirzepatide, you may see significant improvements in your blood sugar control and lipid profile within six months. This includes lower HbA1c, LDL cholesterol, and triglycerides, and higher HDL cholesterol. These improvements contribute to better long-term cardiovascular health. Discuss these potential benefits with your healthcare provider.

The novel long-acting glucagon analogue HM15136 causes dose-dependent fasting plasma glucose elevation and mild weight loss in overweight/obese patients, with hyperglycemia limiting tolerability at higher doses (0.06 mg/kg) in patients with Type 2 Diabetes.

HM15136 is a weekly injection that causes mild weight loss (approx 2-3%) but significantly raises blood sugar. It is not recommended for obesity treatment, especially for those with Type 2 Diabetes, due to safety concerns regarding hyperglycemia. It may be explored for chronic hypoglycemia or in combination with other drugs.

Higher adherence to sports nutrition guidelines, measured by the Athlete Diet Index (ADI), is associated with lower fat mass in professional athletes.

For professional athletes, eating according to sports nutrition guidelines (high ADI score) is linked to having the lowest body fat. For non-professionals, this link is weaker. If you are serious about body composition, aligning your diet with established sports nutrition standards is a key lever, especially if you have access to professional guidance.

Oral supplementation with a specific ratio of three amino acids (3 Glycine : 1 Proline : 1 Hydroxyproline), combined with Vitamin C, astaxanthin, and alpha-ketoglutarate, reduces biological age by approximately 1.4 years in humans over a 6-month period and improves skin texture, hydration, and elasticity within 1-3 months.

Take a daily supplement containing a 3:1:1 ratio of Glycine, Proline, and Hydroxyproline, combined with Vitamin C, Astaxanthin, and Alpha-Ketoglutarate. This specific combination was shown to improve skin texture, hydration, and elasticity within 1-3 months, and reduce biological age by about 1.4 years over 6 months in a clinical trial. It is generally safe, though a small percentage of users may experience mild side effects like rosacea or intestinal reactions.

BCAA supplementation combined with resistance training significantly reduces BMI in young women, whereas meat protein supplementation results in significantly higher final BMI compared to BCAAs.

If you are a young woman doing resistance training, BCAA supplementation might help lower your BMI more effectively than meat protein supplements, though muscle mass gains were not significantly different across groups. Ensure you are consuming enough total protein (approx 1.4g/kg) and training consistently.

Meat protein supplementation combined with resistance training results in significantly higher final body weight and BMI compared to BCAA and vegan protein supplements in young women.

If your goal is to lower BMI while doing resistance training, meat protein supplements might not be the best choice compared to BCAAs or vegan proteins in young women. You may end up with a higher final body weight.

Micronutrient supplementation (Vitamin D, Iron, Calcium, Magnesium) supports health and performance markers, but a balanced diet is often sufficient; supplementation is primarily indicated for deficiencies.

Focus on a balanced diet to meet micronutrient needs. If deficient (e.g., Vitamin D, Iron), follow medical advice for supplementation. Do not assume supplements improve performance without a deficiency.

Household food insecurity is independently associated with higher odds of low muscle mass in U.S. adults, with lower total protein intake acting as a significant partial mediator of this association.

If you are experiencing food insecurity, prioritize protein intake as much as possible, as it is a key factor in maintaining muscle mass. While you cannot control food availability, focusing on protein-rich foods within your budget may help mitigate muscle loss.

Short-duration napping (25-45 minutes) significantly improves mean power output in elite male kickboxers compared to no napping, without affecting countermovement jump height.

Elite kickboxers should consider incorporating 25-45 minute strategic naps before high-intensity training or competition. Ensure the environment is dark and quiet, and avoid screens during the nap. This intervention significantly boosts mean power output without negatively impacting explosive jump height.

Pre-race caffeine intake of 3-6 mg/kg or intra-race intake of 1-2 mg/kg may improve performance in ultra-marathons.

Consider using caffeine to boost performance. Take 3-6 mg/kg before the race and 1-2 mg/kg during the race. Test this during training to avoid GI issues. Caffeine can help with concentration and muscle function in long races.

Virtual Shared Medical Appointments (SMAs) utilizing a lifestyle medicine curriculum (food as medicine, behavioral change, stress management) are an effective implementation model for weight management in obese populations, with program optimization (specifically session timing and structure) significantly improving patient attendance and sustainability.

If you are struggling to lose weight, look for a program that offers group-based lifestyle education (often called Shared Medical Appointments or SMA) delivered virtually. Ensure the program covers nutrition, behavioral strategies (like CBT), and stress management. Crucially, choose a program that offers midday sessions (10 AM - 3 PM) rather than early morning or late evening, as data suggests these times have significantly higher attendance and likely better peer support dynamics. The program should be intensive (e.g., 12 weekly sessions) and include professional guidance from a physician and health coach.