Browse the evidence

Successful weight loss maintainers and normal-weight individuals engage in significantly more light-intensity physical activity (LPA) and spend less time in sedentary behavior (SB) compared to individuals with overweight/obesity.

In addition to structured exercise, try to increase your daily light activity (like standing, slow walking, or household chores) and reduce long periods of sitting. Breaking up sedentary time with standing or light movement can help support your weight management efforts.

Phenotype-tailored interventions improve specific cardiometabolic risk factors, including waist circumference and triglycerides, more effectively than standard lifestyle interventions.

Focus on reducing waist circumference and triglycerides by adhering to a phenotype-tailored plan that ensures a consistent caloric deficit and appropriate physical activity, as this approach has been shown to improve these specific risk factors more than standard advice.

Phenotype-tailored interventions preserve lean mass percentage and resting energy expenditure (REE) better than standard lifestyle interventions.

To maintain muscle and metabolic rate during weight loss, follow a phenotype-tailored plan that includes specific exercise (like HIIT for low REE) and protein timing, as these strategies help preserve lean mass better than standard advice.

Early physical therapy, ambulation, and neuromuscular electrical stimulation (NMES) are potent stimuli that sensitize skeletal muscle to amino acids, helping to retain muscle mass in older ICU patients.

Start moving as soon as medically possible. This includes sitting up, walking, or using electrical stimulation if walking isn't possible. Movement makes your muscles more responsive to the protein you eat, helping to preserve strength and shorten your hospital stay.

Whole food matrices (e.g., whole milk, whole eggs) may enhance muscle protein synthesis rates compared to isolated protein fractions (e.g., skim milk, egg whites) due to synergistic non-protein components like fats and micronutrients.

If you can choose, eat the whole egg (yolk included) or whole milk rather than just egg whites or skim milk. The fats and vitamins in the yolk/milk fat may give your muscles a slight extra boost in building protein.

High cardiorespiratory fitness (CRF) can neutralize the increased risk of type 2 diabetes associated with statin use, whereas low or moderate CRF does not.

If you take statins, maintaining high cardiorespiratory fitness is crucial to offset the potential increased risk of type 2 diabetes. While statins are linked to higher diabetes risk in less fit individuals, those with high fitness levels do not show this increased risk. Prioritize cardiovascular exercise to maintain high fitness if you are on statin therapy.

In patients with inflammatory bowel disease (IBD) and obesity, weight loss therapy should prioritize selective fat mass reduction while preserving lean body mass (muscle) to avoid worsening sarcopenia and surgical risk.

If you have IBD and are overweight, your weight loss goal is different from the general population. You must prioritize keeping your muscle mass. Standard diets that just cut calories might hurt your muscles. You need a plan that specifically protects lean body mass, likely involving higher protein intake and monitoring muscle function, not just the scale number.

In patients with type 2 diabetes duration greater than 10 years, GLP-1RA plus basal insulin fixed-ratio combinations (iDegLira, iGlarLixi) may be numerically more effective for HbA1c reduction than tirzepatide, suggesting tirzepatide is better suited for early-stage disease.

For patients with type 2 diabetes for more than 10 years, GLP-1RA plus basal insulin fixed-ratio combinations may offer better glycemic control than tirzepatide alone, making them a strong option for long-standing disease.

Withholding GLP-1 receptor agonists for at least three half-lives before elective surgery is recommended for weight management patients to minimize retained gastric contents.

For weight loss patients: Check the half-life of your specific drug (e.g., Semaglutide ~7 days, Dulaglutide ~5 days). Stop taking it at least 3 times that duration before your scheduled surgery. For example, if you take Semaglutide (7-day half-life), stop at least 21 days before surgery. Consult your doctor for a bridge plan for blood sugar if applicable.

For patients with Type 2 Diabetes, prolonged cessation of GLP-1 receptor agonists may worsen peri-operative glycaemic control, requiring individualized management and endocrinologist consultation.

If you have Type 2 Diabetes, do not simply stop your GLP-1 drug without a plan. Stopping it can cause your blood sugar to rise dangerously high during surgery. You need a personalized plan from your doctor and likely an endocrinologist to manage your sugar levels during the period you are off the drug.

For adults with marginal or inadequate protein intake (<0.8 g/kg/day), consuming a more balanced protein distribution (spreading protein across meals) is superior to an unbalanced distribution for promoting skeletal muscle-related outcomes.

If you are currently eating less than 0.8 grams of protein per kilogram of body weight per day, try spreading your protein out more evenly across your meals. This helps your body use the protein it has more efficiently. However, if you are already eating a healthy amount of protein (0.8-1.3 g/kg), you don't need to stress about balancing every meal; just make sure at least one meal has enough protein (around 25-30g) to trigger muscle building.

For adults with adequate or high protein intake (0.8-1.3 g/kg/day), ensuring at least one meal contains sufficient protein to maximally stimulate muscle protein synthesis is sufficient for promoting skeletal muscle health, regardless of how the rest of the day's protein is distributed.

If you are already eating enough protein each day (around 0.8 to 1.3 grams per kilogram of body weight), you don't need to worry about spreading it out perfectly. Just make sure one meal a day has enough protein (about 25-30 grams) to trigger muscle building. The rest of your protein can be distributed however fits your schedule.

Long-term metformin therapy (up to 10 years) in overweight-obese women with PCOS and normal baseline glucose homeostasis results in significant initial weight loss, stabilization of body mass, improved menstrual frequency, and reduced androgen levels, with a very low conversion rate to diabetes.

For overweight or obese women with PCOS who have normal blood sugar, metformin (up to 2000mg/day) can help with weight loss, menstrual regularity, and lowering male hormones. The biggest weight loss happens in the first year, after which weight stabilizes. It is generally well-tolerated, but sticking with it long-term is hard because the initial excitement fades. Consistent use helps maintain these benefits and prevents diabetes.

Implementing national produce prescription programs for US adults with diabetes and food insecurity prevents cardiovascular disease events and generates quality-adjusted life years while being highly cost-effective.

For policymakers and healthcare systems, integrating produce prescriptions into care for diabetic, food-insecure patients is a financially sound investment that improves long-term health outcomes and reduces overall societal costs.

Specific genetic variants (e.g., FTO, TCF7L2, FABP2) modify the body's response to macronutrient intake, such that high-protein or specific fat/carbohydrate ratios yield different weight loss or metabolic outcomes depending on the individual's genotype.

If you have known genetic risks (like FTO variants), standard high-carb or low-fat diets might not be optimal. Consider discussing with a professional whether a high-protein or specific fat-modified diet aligns with your genetic profile for better weight management.

Dietary interventions targeting gut microbiota composition (e.g., prebiotics, probiotics, or specific fiber types) can improve glucose homeostasis and insulin sensitivity in obese individuals, particularly by modulating the Firmicutes/Bacteroidetes ratio and reducing pro-inflammatory bacterial species.

Focus on dietary fibers and fermented foods to support a healthy gut microbiome. This may help improve insulin sensitivity and reduce inflammation, which are key drivers of obesity and metabolic syndrome.

A slow digestion-oriented dietary strategy that delivers nutrients to the distal small intestine and colon sustains GLP-1 secretion, thereby improving glucose homeostasis.

To improve blood sugar control, choose foods that digest slowly. This includes whole grains, viscous fibers, and foods with natural enzyme inhibitors. The goal is to get nutrients to your lower intestine to trigger sustained GLP-1 release, which helps manage glucose levels over a longer period.

Omega-3 polyunsaturated fatty acids (n-3 PUFA), specifically EPA and DHA, can reduce body fat mass and abdominal adiposity, but may not significantly reduce total body weight in overweight or obese individuals when used as a supplement alone.

Omega-3 supplements (EPA/DHA) may help reduce body fat, especially abdominal fat, but are unlikely to cause significant total weight loss on their own. They are most effective when combined with calorie restriction and exercise.

High consumption of ultra-processed foods (UPFs) is associated with specific alterations in gut microbiota composition, including decreased Lachnospira and Ruminococcus species and increased Prevotella species, though effects on overall microbial diversity (alpha/beta) are inconsistent across studies.

If you consume a high amount of ultra-processed foods, you may see a shift in your gut bacteria, specifically a decrease in beneficial fiber-fermenting types like Lachnospira and an increase in Prevotella. While overall diversity might not change significantly in all cases, these specific shifts are linked to higher UPF intake. To support a healthier microbiome, consider reducing UPF intake and increasing fiber-rich whole foods.

High consumption of ultra-processed foods is associated with negative health outcomes including increased depression/anxiety, higher BMI/weight, and decreased HDL cholesterol, particularly in men consuming >5 servings/day.

Eating more than 5 servings of ultra-processed foods daily is linked to higher body weight, worse cholesterol (lower HDL in men), and higher rates of depression and anxiety in women. Reducing UPF intake below this threshold may help improve these health markers.

Highly processed, palatable, and cheap foods (high in sugar, fat, salt, and flavor additives) trigger overconsumption of calories by shifting eating behaviors from home cooking to snacking and large-portion meals.

Prioritize whole, unprocessed foods over highly processed options. Be aware that processed foods with added sugar, fat, and salt are engineered to promote overconsumption, making portion control difficult.

The reduction in occupational physical activity, rather than a lack of formal exercise, is a major contributor to the obesity epidemic, creating a zone of low energy expenditure where intake becomes uncoupled from expenditure.

Incorporate movement into your workday. If your job is sedentary, try to stand, walk, or move frequently during the day, as this has a larger impact on daily energy expenditure than formal exercise alone.

High intake of dietary fiber, particularly soluble and cereal fiber, improves glycemic control, reduces HbA1c, and lowers the risk of type 2 diabetes.

Increase your daily intake of dietary fiber by eating more fruits, vegetables, legumes, nuts, and whole grains. This can significantly improve blood sugar control, lower HbA1c, and reduce the risk of type 2 diabetes.

GLP-1 agonists (specifically liraglutide and exenatide) induce significant weight loss in patients with antipsychotic-induced weight gain (AIWG) without worsening psychiatric symptoms.

For patients gaining weight from antipsychotics, GLP-1 agonists like liraglutide or exenatide are effective tools for weight loss. Liraglutide shows stronger results (-4.7 kg) than exenatide (-2.5 kg). These drugs do not worsen mental health symptoms, making them safe adjuncts to antipsychotic therapy. Side effects like nausea are common but usually manageable.