Browse the evidence

Digital weight-loss services (DWLSs) mitigate obesity care access barriers by providing asynchronous multidisciplinary care, reducing psychological stigma, and offering scheduling flexibility, thereby enabling patients who failed face-to-face general practitioner (GP) care to access comprehensive treatment.

If you have struggled to lose weight due to shame, anxiety, or lack of time for doctor visits, a digital weight-loss service may offer a more accessible and less stigmatizing path to care than traditional face-to-face general practice. Look for services that offer multidisciplinary support (dietitians, coaches) alongside medication, rather than just medication dispensing.

A significant proportion of patients subscribe to digital weight-loss services primarily to access GLP-1 receptor agonist (GLP-1 RA) medications after failing stand-alone lifestyle interventions, supporting the critique that some DWLSs function primarily as medication access pathways.

If you have tried diet and exercise without success, you are not alone. Digital services that offer GLP-1 medications may be a viable option, but ensure they provide medical supervision and are not just a direct-to-consumer pharmacy.

Omega-3 polyunsaturated fatty acid (n-3PUFA) supplementation (≥2-4 g/day) enhances muscle protein synthesis and strength in older women, but may not provide significant benefits for older men.

Older women considering omega-3 supplements for muscle health should aim for at least 2-4 grams per day, especially if doing resistance training. Older men may not see the same muscle-building benefits from this specific supplement.

Integrating telephone-delivered health coaching with standard multidisciplinary care for severe obesity yields non-inferior weight loss and glycemic improvements compared to multidisciplinary care alone, while significantly improving patient acceptability and access.

If you have severe obesity and struggle to attend frequent specialist appointments, adding a structured telephone coaching program to your standard care can help you stay on track. While it may not guarantee more weight loss than standard care alone, it significantly improves your ability to adhere to the diet and psychological support, and is highly accepted by patients.

GLP-1 receptor agonist (GLP-1RA) therapy is associated with clinically relevant risks of protein, vitamin, and mineral deficiencies due to reduced caloric and nutrient intake.

If you are taking a GLP-1 medication like semaglutide or tirzepatide, you are likely eating less, which means you might not be getting enough vitamins and minerals. You should prioritize nutrient-dense foods and discuss baseline blood testing for Vitamin D, B12, Iron, and Calcium with your doctor. Do not assume that because this is a medication and not surgery, you are exempt from nutritional monitoring.

GLP-1RA therapy frequently leads to inadequate protein intake, resulting in loss of lean body mass and potential sarcopenia.

To prevent muscle loss while on GLP-1 medication, you must consciously prioritize protein in your diet. Aim for 1.2-2.0 grams of protein per kilogram of body weight daily. If you are struggling to eat enough protein, consider high-protein food choices or supplements, and discuss this with your healthcare provider.

Weight loss interventions (pharmacological or bariatric) in sarcopenic obesity can improve muscle-specific strength and functional parameters despite absolute muscle mass loss, potentially reversing the sarcopenic obesity diagnosis.

If you are considering weight loss medication for obesity, discuss the potential benefits for muscle function. Even if you lose some muscle mass, your strength and ability to function may improve due to reduced fat in muscles and better metabolism. This can reverse sarcopenic obesity.

Shifting focus from weight loss to body recomposition (muscle gain/fat loss) and behavioral goals improves long-term sustainability and psychological outcomes in PCOS.

Do not obsess over the scale. In PCOS, health benefits like better insulin sensitivity and mood come from healthy habits, not just weight loss. Focus on building muscle and moving regularly. This approach is more sustainable and avoids the psychological harm of weight cycling.

The Mediterranean Diet (MedDiet) improves cardiometabolic risk factors, insulin resistance, and hyperandrogenism in PCOS.

Adopt a Mediterranean-style diet: eat plenty of vegetables, fruits, legumes, and whole grains. Use olive oil as your main fat, eat fish and nuts regularly, and limit red meat and processed foods. This pattern helps improve insulin resistance and hormone levels in PCOS.

Post-intervention weight regain occurs after a workplace weight-loss program, with participants regaining approximately half of their initial weight loss within 3-6 months if contact frequency is reduced.

Plan for maintenance from day one. After your initial weight loss program ends, schedule regular check-ins (monthly or quarterly) with a coach or support group to prevent regaining the weight. Do not assume the weight will stay off without continued effort.

Consuming a protein- and leucine-enriched bar (containing ~16g protein and 1.5g free leucine) two hours after a low-protein breakfast increases peak plasma leucine and essential amino acid exposure to levels comparable to a high-protein breakfast, while significantly reducing hunger and increasing fullness in older adults.

For older adults who struggle to eat large breakfasts, adding a small, leucine-enriched protein bar about two hours after a light breakfast can boost muscle-building signals and keep hunger away just as effectively as a much larger, high-protein breakfast. Look for bars with ~1.5g of free leucine and ~16g of mixed protein.

In individuals with prediabetes, consuming a high-energy breakfast (50% of daily energy) compared to a low-energy breakfast (20%) during prolonged sitting results in significantly higher total daily glucose and insulin exposure, despite similar 24-hour continuous glucose monitoring averages.

If you have prediabetes and sit for long periods, avoid making your first meal the largest of the day. This study found that a high-energy breakfast led to higher overall glucose and insulin exposure compared to a low-energy breakfast, even though the total calories and macros were identical. Consider eating a smaller breakfast and a larger dinner to minimize postprandial glucose spikes during sedentary work.

While high-energy breakfast increases total glucose and insulin exposure, it does not significantly alter 24-hour mean glucose or glycaemic variability as measured by continuous glucose monitoring (CGM) compared to low-energy breakfast.

Don't worry if your 24-hour glucose monitor looks the same regardless of when you eat your biggest meal. However, be aware that a large breakfast causes higher spikes and deeper dips in glucose throughout the day, which may have long-term vascular implications even if the average looks normal.

Vigorous federal, state, and community financial assistance programs during the COVID-19 pandemic significantly improved food security and the healthfulness of food choices for a majority of US adults, particularly among lower-income and minority demographics.

If you are facing food insecurity or struggling to eat healthily during a crisis, prioritize accessing available government assistance programs (like SNAP, emergency food benefits, or community aid). These programs are designed to remove the financial and access barriers that prevent healthy eating, and data shows they can successfully improve both food security and diet quality for vulnerable populations.

Treatment with GLP-1 receptor agonists (semaglutide or dulaglutide) significantly reduces biochemical markers of liver fibrosis (FIB-4 score) and inflammation (De Ritis ratio) in patients with type 2 diabetes and MASLD over 180 days.

For patients with Type 2 Diabetes and fatty liver disease, GLP-1 agonists like semaglutide or dulaglutide (taken weekly) can significantly improve liver health markers (specifically fibrosis risk scores) over 6 months, even without changes to diet or exercise. This suggests these drugs offer liver-specific benefits beyond just weight loss or blood sugar control.

Once-weekly subcutaneous semaglutide (1 mg) produces clinically significant weight loss (median 4.4% in diabetics, 3.4% in non-diabetics) and improves glycemic control (HbA1c reduction of 0.4%) in patients with type 2 diabetes over 6 months.

If you have Type 2 Diabetes, once-weekly semaglutide (starting at 0.25mg and titrating up to 1mg) is a proven tool for losing weight (average ~4-5%) and improving blood sugar control. It works by mimicking a gut hormone to slow digestion and regulate insulin. While nausea is common, it is usually mild. It is not a magic bullet; you still need to eat a balanced diet, but the drug significantly aids the process.

Semaglutide (1 mg) promotes significant weight loss and improves BMI in patients without Type 2 Diabetes, without causing significant changes in HbA1c or hypoglycemia risk.

If you do not have diabetes but struggle with weight, semaglutide (1 mg weekly) can help you lose about 3-4% of your body weight. Because it works based on blood sugar levels, it does not typically cause dangerous low blood sugar (hypoglycemia) in non-diabetics. It is used off-label for this purpose but is supported by clinical guidelines.

Semaglutide improves cardiometabolic risk factors, including diastolic blood pressure, in patients without diabetes, while maintaining renal stability in both diabetic and non-diabetic populations.

Semaglutide offers cardiovascular benefits beyond weight loss, such as lowering diastolic blood pressure in non-diabetics. It also appears to protect kidney function (stable creatinine and albumin/creatinine ratio) in both diabetic and non-diabetic patients, making it a favorable option for those with cardiometabolic risks.

Targeting energy expenditure through thermogenic pathways (such as UCP1, futile creatine, calcium, or lipid cycles) is a viable therapeutic strategy for promoting negative energy balance and sustaining weight loss, distinct from appetite suppression.

While lifestyle changes are foundational, they often fail long-term due to biological counter-regulation. Future treatments may focus on boosting energy expenditure through specific cellular mechanisms (like thermogenesis in fat or muscle) rather than just restricting calories. For now, understanding that your body fights weight loss through increased hunger and reduced expenditure is key to managing expectations.

Consumption of protein supplements by muscle builders significantly alters gut microbiome composition and fecal metabolome, specifically increasing the abundance of Lactobacillales and allantoin while decreasing nucleotide metabolism gene expression compared to non-supplement users.

If you use protein supplements, your gut bacteria and metabolites will look different than non-users, specifically with higher levels of Lactobacillales and allantoin. This is a normal adaptation to higher protein/purine intake and does not imply negative health effects in this population.

Moderate consumption of eggs (1-2 per day) is safe and potentially healthy for most individuals, provided they replace refined carbohydrates or unhealthy meats.

You can safely eat 1-2 eggs per day. They are a healthy source of protein and nutrients. Just make sure you are eating them as part of a balanced diet, not alongside refined carbohydrates or processed meats.

Zinc supplementation (50 mg oral zinc acetate, 2x/day for 14 weeks) improves insulin secretion specifically in individuals with the SLC30A8 rs13266634 CT/TT genotype, demonstrating a genotype-dependent response to micronutrient intervention.

If you are considering zinc supplementation for insulin resistance, check your SLC30A8 genotype first. If you carry the CT or TT variant of rs13266634, 50mg of zinc acetate twice daily for 14 weeks may significantly boost your fasting insulin levels. If you have the CC genotype, this specific intervention may not offer the same benefit.

High adherence to a Mediterranean diet improves inflammatory biomarkers (triglycerides, hsCRP) in individuals with the TNF rs1800629 GG genotype, demonstrating that dietary patterns can modulate genetic inflammation risk.

If you have the TNF rs1800629 GG genotype, you are genetically predisposed to higher inflammation and triglycerides. Adopting a Mediterranean diet for at least one year can significantly improve these markers, reducing your cardiovascular risk. This is a key example of how diet can counteract genetic inflammation.

Among obese individuals, frequent or daily alcohol consumption and extra salt intake are independent risk factors for metabolic syndrome, whereas physical inactivity and sugar-sweetened drink consumption do not show statistically significant associations.

If you are obese, managing your weight is crucial, but it is not the only lever. This research suggests that for obese individuals, cutting out daily alcohol and reducing extra salt at the table are critical, specific actions to lower metabolic syndrome risk, potentially more so than just increasing exercise or cutting sugary drinks in this specific demographic.