Browse the evidence

In obese men, upper body obesity (higher waist-to-thigh ratio) is associated with a significantly higher basal metabolic rate (BMR) compared to lower body obesity, independent of fat-free mass, fat mass, and age.

For obese men, carrying more weight around the waist (visceral fat) is linked to a higher resting metabolic rate than carrying weight on the hips/thighs. This metabolic difference does not appear to exist in obese women in this study. Focus on overall health markers rather than just total weight.

Excess caloric intake, particularly from carbohydrates (fructose/glucose) and saturated fats, drives de novo lipogenesis and hepatic fat accumulation, whereas unsaturated fats (omega-3) may reduce liver fat.

Focus on reducing added sugars (especially fructose/sweetened beverages) and saturated fats. Replace them with unsaturated fats (like omega-3s) and whole food carbohydrates. Total calories matter, but what you eat matters more for your liver.

Tirzepatide treatment (5-15 mg once weekly) significantly improves health-related quality of life (HRQoL), including physical function and psychosocial well-being, compared to placebo in adults with obesity or overweight.

If you have obesity or overweight, treatment with tirzepatide (5-15 mg once weekly) along with lifestyle changes significantly improves your quality of life, physical function, and mental well-being compared to placebo. The greater the weight loss achieved (especially ≥5%), the greater the improvement in how you feel and function daily.

Greater degrees of weight reduction achieved with tirzepatide are associated with greater improvements in health-related quality of life (HRQoL), particularly when weight loss is ≥5%.

With tirzepatide, you don't need to lose a massive amount of weight to see benefits. Losing 5% or more of your body weight is associated with noticeable improvements in how you feel and function, with greater losses leading to even better outcomes.

Post-resistance exercise protein ingestion in a state of short-term energy deficit selectively promotes autophagic signaling (specifically cAtg12 and FOXO1) compared to placebo, potentially facilitating muscle remodeling despite reduced baseline autophagy markers.

If you are cutting calories and lifting weights, consume 30g of whey protein immediately after your workout. This specific timing and dose helps regulate autophagy (a cellular recycling process) in a way that placebo does not, potentially supporting muscle remodeling even when you are in a caloric deficit.

High consumption of 'savory-fatty' tasting foods is associated with increased total energy intake and overweight status, whereas 'neutral' tasting foods are consumed in lower proportions by high-energy consumers.

Focus on the taste profile of your diet, not just processing levels. High intake of 'savory-fatty' foods (common in many processed dishes) is strongly linked to higher energy consumption and overweight status in this population. To manage weight, consider reducing the proportion of energy derived from savory-fatty clusters and increasing neutral-tasting foods, which were consumed in higher proportions by those with lower energy intake.

The association between sweet taste and sugar content is weaker in ultra-processed foods compared to unprocessed foods, potentially due to the use of non-saccharide sweeteners.

Be aware that sweet taste in ultra-processed foods does not always correlate with high sugar content. Manufacturers may use non-saccharide sweeteners to maintain sweetness while reducing sugar, which can disrupt your body's ability to predict energy intake based on taste alone.

Lifestyle modification resulting in 7% weight loss and 150-175 minutes per week of physical activity can reduce the relative risk of obesity-related cancer by 16%, suggesting the effects of obesity on cancer risk may be reversible.

Aim for a 7% weight loss and 175 minutes of physical activity per week. While the cancer risk reduction in the major trial was not statistically significant, the trend suggests that maintaining a healthy weight through diet and exercise is a powerful way to lower your cancer risk.

Caloric restriction triggers adaptive thermogenesis, including reduced BMR/RMR, hormonal shifts (lowered T3, leptin, increased ghrelin), and increased appetite, which persist long-term and contribute to weight regain.

When you restrict calories, your body fights back by lowering your metabolic rate and increasing hunger hormones. This is a survival mechanism, not a personal failing. To manage this, consider strategies that preserve muscle mass, manage stress, and perhaps use precision nutrition to mitigate these adaptive responses.

Sustained lockdown-induced sedentary behavior and dietary shifts in healthy adults cause significant worsening of cardiovascular risk factors, including increased BMI, body fat, LDL cholesterol, blood glucose, and blood pressure.

Maintain physical activity and monitor dietary intake during periods of restricted movement. The study shows that even healthy adults experience measurable declines in metabolic health (weight, lipids, glucose) when sedentary, highlighting the need for proactive lifestyle management during lockdowns or similar restrictions.

Mandatory menu calorie labeling in US chain restaurants reduces cardiovascular disease and type 2 diabetes incidence, generating net healthcare and societal cost savings.

Support and comply with menu calorie labeling laws. While individual behavior change is modest, the population-level effect prevents thousands of heart attacks and diabetes cases, saving billions in healthcare costs.

Cotadutide, a dual GLP-1 and glucagon receptor agonist, significantly reduces urinary albumin-to-creatinine ratio (UACR) in patients with type 2 diabetes and chronic kidney disease compared to placebo, with effects sustained over 26 weeks.

If you have type 2 diabetes and early kidney disease, cotadutide (a daily injection) significantly reduces albumin in your urine, a key marker of kidney health. This effect is seen at higher doses (300-600 mg) and is sustained over time. It works on top of your current medications. While it causes some GI side effects, these are generally manageable and similar to other GLP-1 drugs. Discuss with your doctor if this dual-agonist approach is right for you, especially if you are not getting enough kidney protection from current treatments.

A behavioral weight loss maintenance intervention involving monthly brief contacts provides a modest but statistically significant long-term advantage in weight loss retention compared to a self-directed approach, even if the benefit of extending the intervention itself is null.

If you are trying to maintain weight loss, engaging in a structured maintenance program (like monthly check-ins with a coach or a structured app) for the first 2-3 years can help you retain more weight than trying to do it entirely on your own. However, you do not necessarily need to stay in that program forever.

During weight-loss maintenance, a high-carbohydrate diet (60% energy) significantly reduces late postprandial circulating energy availability compared to a low-carbohydrate diet (20% energy), primarily by suppressing free fatty acids.

If you are maintaining weight loss, be aware that high-carbohydrate meals may reduce the amount of fat available for your body to burn in the hours after eating, primarily due to insulin effects. This doesn't mean you will gain weight if you stay in a calorie deficit, but it may make you feel less energetic or hungrier later if your body is relying on stored fat. Experiment with lower carbohydrate ratios (e.g., 20-40%) to see if it improves your satiety and energy stability.

Obesity is an independent risk factor for the onset and progression of chronic kidney disease (CKD), with visceral adiposity and fatty kidney disease serving as key pathophysiological mediators.

Maintaining a healthy weight is critical for kidney health. Excess visceral fat directly harms kidney function through inflammation and blood pressure changes. Weight management is a primary strategy to prevent or slow kidney disease.

GLP-1 receptor agonists (e.g., semaglutide) induce significant weight loss and reduce albuminuria, offering potential kidney protection, though their direct impact on eGFR decline in normal-functioning kidneys is not yet fully established.

GLP-1 medications like semaglutide help with weight loss and have been shown to reduce albuminuria (a sign of kidney stress). They are a promising option for kidney protection, especially for those with diabetes and obesity.

GLP-1 receptor agonists (specifically semaglutide and liraglutide) improve liver histology in MASH patients, with semaglutide demonstrating the strongest evidence for resolving steatohepatitis without worsening fibrosis.

If you have MASH, GLP-1 medications like semaglutide are currently the most evidence-backed pharmacological option to improve liver health, potentially resolving the disease without worsening scarring. This is particularly relevant if you also have Type 2 Diabetes or obesity, as these drugs address the underlying metabolic drivers. While weight loss contributes, the histological benefits appear to extend beyond weight reduction alone.

Liraglutide (1.8 mg) improves liver enzymes and reduces hepatic steatosis in MASH patients, though its ability to resolve NASH histology is modest compared to semaglutide.

Liraglutide 1.8 mg can significantly lower liver enzymes (ALT/AST) and reduce liver fat in MASH patients. However, it is less effective than semaglutide at fully resolving the inflammation (NASH) itself, so it may be a good option for enzyme control but less so for complete histological reversal.

Resistance training performed to volitional failure induces microvascular expansion (increased capillary-to-fiber ratio, capillary contacts, and capillary-to-fiber perimeter exchange index) regardless of whether the load is high (75-90% 1RM) or low (30-50% 1RM).

If you want to improve the blood supply to your muscles, you don't need to lift heavy weights. As long as you perform resistance exercises to the point of failure, using either light weights for many reps or heavy weights for fewer reps, you will get the same microvascular benefits. Focus on reaching failure rather than obsessing over the specific weight on the bar.

Pharmacotherapy (Orlistat, Lorcaserin, Phentermine/Topiramate) serves as an effective adjunct to lifestyle modifications for patients with BMI >= 30 or >= 27 with comorbidities who fail to achieve adequate weight loss with lifestyle changes alone.

If lifestyle changes alone aren't enough after 6 months, discuss FDA-approved weight-loss medications with your doctor. Orlistat (120mg 3x/day) blocks fat absorption. It works best with a low-fat diet. Be aware of potential gastrointestinal side effects, which can be minimized by eating less fat. Take a multivitamin at a different time of day.

Using a preceding 24-hour calorimeter stay (Prestudy Day) to estimate energy expenditure is the most accurate method for achieving 24-hour energy balance in subsequent assessments, significantly outperforming regression equations based on anthropometrics, body composition, or resting/sleeping metabolic rates.

If you are conducting precise metabolic research requiring strict energy balance, using a subject's own 24-hour energy expenditure from a prior stay in a calorimeter is the gold standard for predicting their needs. While less accurate methods like Harris-Benedict or RMR-based equations exist, they introduce significant error. Use these simpler methods only if resources for a prestudy calorimeter stay are unavailable, understanding that prediction accuracy will be lower.

Bariatric surgery is indicated for adults with Type 2 Diabetes and BMI ≥35 kg/m² who cannot control their condition with lifestyle and pharmacological treatment, leading to remission in 40-95% of cases.

If you have Type 2 Diabetes and a BMI of 35 or higher, and lifestyle changes and medications aren't working well, discuss bariatric surgery with your doctor. It can put diabetes into remission for many people, but requires lifelong medical monitoring.

Consuming a higher variety of protein sources (from 8 major food groups) at their respective appropriate quantity windows is inversely associated with the risk of new-onset hypertension.

To lower your risk of high blood pressure, focus on eating a wide variety of protein sources—such as grains, red meat, poultry, fish, eggs, and legumes—rather than just increasing total protein. Ensure you are eating these sources in moderate, balanced amounts, as both too little and too much of specific types can increase risk. Aim for a diverse diet that includes small portions from each of these major protein groups.

There is no single 'appropriate' amount for all protein sources; each source (red meat, poultry, fish, etc.) has a unique non-linear relationship with hypertension risk, requiring source-specific quantity windows.

Don't just focus on hitting a total protein number. Pay attention to what kind of protein you are eating. Some sources like red meat and poultry may increase risk if eaten in excess, while others like legumes and eggs may offer protection. A balanced mix of moderate amounts from various sources is key.