Browse the evidence

Visceral adipose tissue (VAT) is a stronger predictor of mortality risk than overall BMI or subcutaneous adipose tissue (SAT), while SAT may be associated with lower mortality risk.

Do not rely on BMI alone to assess your health risk. Focus on reducing visceral fat (belly fat) through exercise and diet, as it is a stronger predictor of mortality than overall weight. Subcutaneous fat (fat under the skin) may be less harmful or even protective.

Caloric restriction and time-restricted feeding can extend healthspan and lifespan in animal models and improve metabolic health in humans, sometimes without weight loss, by reshaping molecular pathways in adipose tissue and aligning with circadian rhythms.

Try time-restricted feeding or caloric restriction without focusing solely on weight loss. Align your eating window with your circadian rhythm (e.g., eat earlier in the day) to maximize metabolic benefits and potentially extend healthspan, even if your weight doesn't change.

A short food-frequency questionnaire (SFFQ) with 50 items provides adequate agreement and reproducibility with a comprehensive 161-item questionnaire for ranking dietary intake of major food groups and macronutrients in men with prostate cancer.

For researchers or clinicians studying diet in prostate cancer patients, using a validated 50-item short questionnaire is a viable strategy. It takes only 15 minutes to complete and accurately ranks patients' intake of major food groups (like fruits, dairy, and seafood) compared to much longer surveys. This reduces participant burden and increases the feasibility of long-term studies, though it may be less accurate for total fat intake.

Intensive glycemic control (target HbA1c < 6%) significantly reduces the development of diabetic peripheral neuropathy (DPN) in patients with Type 1 Diabetes Mellitus (T1DM), but this benefit is not observed in patients with Type 2 Diabetes Mellitus (T2DM).

If you have Type 1 Diabetes, aiming for an HbA1c below 6% is the most effective way to prevent nerve damage. However, if you have Type 2 Diabetes, this aggressive target is not recommended due to lack of neuropathy benefit and increased mortality risk; standard control (7.0-7.9%) is advised instead.

VLCKD improves glycemic profiles (fasting glucose, HbA1c, HOMA-IR) and lipid profiles (triglycerides, total cholesterol) significantly, with some improvements (glycemia, LDL) being similar to other weight loss interventions.

You can expect your blood sugar, insulin resistance, and cholesterol numbers to improve significantly on VLCKD. However, for these specific metabolic markers, the improvement is comparable to what you might get from any other effective weight loss diet, whereas fat loss is specifically better on VLCKD.

Exercise-induced weight loss produces superior improvements in adipokine profiles (increased adiponectin, decreased chemerin), insulin resistance, and systemic inflammation compared to diet-induced weight loss, despite achieving equivalent total body weight reduction.

If your goal is to improve metabolic health, insulin sensitivity, and reduce inflammation, prioritize exercise over strict calorie restriction, even if your total body weight doesn't drop as quickly. Exercise is more effective at targeting fat loss and improving your body's hormonal response to food than dieting alone, provided you maintain a similar energy deficit.

Excess dietary fat intake leads to fat storage because the body lacks stringent metabolic control over fat oxidation compared to carbohydrates and proteins.

To maintain a healthy body weight, you must balance your total energy intake with expenditure. While all calories contribute to energy balance, the body handles excess fat differently than carbs or protein, storing it more readily. Therefore, managing total caloric intake, particularly from fat, is crucial for preventing fat accumulation.

The metabolic benefits of the multifaceted intervention, specifically reductions in fasting insulin and IL-6, occur rapidly, with the greatest decreases observed by week 6 of the 12-week program.

If you start this combined lifestyle program, expect significant improvements in insulin sensitivity and inflammation within the first 6 weeks, even if full fat loss continues until week 12.

Semaglutide significantly improves glycemic control (HbA1c and fasting blood glucose) and systolic blood pressure in overweight or obese adults, with or without type 2 diabetes.

Semaglutide not only helps with weight loss but also significantly improves blood sugar control (HbA1c and fasting glucose) and lowers systolic blood pressure in overweight or obese individuals, offering potential cardiovascular benefits.

Bariatric surgery (Roux-en-Y gastric bypass, sleeve gastrectomy, or biliopancreatic diversion) produces significantly greater body weight loss and higher remission rates of type 2 diabetes and metabolic syndrome compared to non-surgical treatment (diet, behavioral therapy, or pharmacotherapy) in individuals with a BMI ≥30, with effects sustained up to two years.

For individuals with a BMI of 30 or higher, bariatric surgery (specifically Roux-en-Y, sleeve, or biliopancreatic diversion) is significantly more effective than diet and lifestyle changes alone for losing weight and reversing type 2 diabetes. While surgery carries risks like anemia or the need for reoperation, the long-term benefits for metabolic health and weight maintenance are superior to non-surgical treatments, especially for those who have failed previous weight loss attempts.

Bariatric surgery (specifically Roux-en-Y gastric bypass, sleeve gastrectomy, and biliopancreatic diversion) leads to greater improvements in cardiovascular risk factors (triglycerides, HDL cholesterol, fasting glucose, HbA1c) compared to non-surgical treatment, although blood pressure and total/LDL cholesterol changes are not significantly different.

Bariatric surgery improves key cardiovascular markers like triglycerides, HDL cholesterol, and blood glucose more effectively than non-surgical treatments. However, it does not significantly improve blood pressure or LDL cholesterol compared to lifestyle changes alone. Patients should expect to reduce or stop some medications under medical supervision.

Obese individuals significantly underestimate their caloric intake and overestimate their physical activity levels when self-reporting, leading to a discrepancy between reported and actual energy expenditure and intake.

If you are obese, your memory of what you ate and how much you exercised is likely inaccurate. You probably eat more and move less than you think. Relying on self-reported logs for weight loss will likely fail because the baseline data is wrong. Use objective tracking methods (like doubly labeled water for research or calibrated devices for clinical use) if precise energy balance is required.

Overweight and obese individuals experience a greater suppression of energy intake and more pronounced weight loss from increased fiber intake compared to lean individuals.

If you are overweight, increasing your fiber intake is likely to be more effective for weight loss than if you are lean. You can expect a larger weight loss benefit (approx. 2.4 kg) compared to lean individuals (approx. 0.8 kg) when adding 14g of fiber daily.

A low-carbohydrate diet preserves HDL cholesterol levels better than a conventional low-fat diet in severely obese adults, independent of weight loss.

Switching to a low-carbohydrate diet can help maintain your 'good' HDL cholesterol levels, which tend to drop on low-fat diets. This is a specific metabolic benefit that occurs even if your weight loss is the same as on a low-fat diet.

A very-low-carbohydrate ketogenic diet (VLCKD) significantly improves triglycerides (TAG) and diastolic blood pressure (DBP) compared to a low-fat diet (LFD) over the long term, but also increases LDL-C and HDL-C levels.

Switching to a very-low-carb diet improves triglycerides and blood pressure more than a low-fat diet, but it will raise your LDL and HDL cholesterol. Discuss these changes with your doctor, as the increase in LDL may be less harmful than traditionally thought due to particle size changes.

Resistance exercise improves strength and function but does not significantly enhance weight loss or preserve fat-free mass during caloric restriction.

Include resistance training in your weight loss plan to improve your strength and daily function. However, do not expect it to stop you from losing muscle mass along with fat. You will likely lose some fat-free mass regardless of resistance training if you are in a caloric deficit. Prioritize protein intake and strength gains rather than expecting resistance training to preserve muscle mass perfectly.

Once-weekly semaglutide (1.0 mg) reduces ad libitum energy intake by approximately 24% through mechanisms of reduced appetite, improved control of eating, and lower preference for high-fat foods, leading to significant body weight loss without compensatory increases in energy expenditure.

Take once-weekly semaglutide (titrated to 1.0 mg over 12 weeks) to reduce hunger, improve control over eating, and lower preference for high-fat foods. This leads to a ~24% reduction in daily calorie intake and significant fat loss, without needing to increase exercise or metabolic rate. Expect mild GI side effects initially.

Weight loss improves insulin sensitivity primarily through the reduction of visceral adipose tissue (VAT), whereas changes in total fat mass or subcutaneous abdominal fat do not significantly predict this improvement.

To improve insulin sensitivity, focus on losing visceral fat through caloric restriction. While total weight loss occurs, the specific reduction of visceral adipose tissue is the primary driver of metabolic improvement, not just the total amount of weight or subcutaneous fat lost. A moderate weight loss (e.g., 15%) is sufficient to significantly improve insulin sensitivity, primarily by targeting visceral stores.

Both diet-only and diet-plus-exercise interventions are associated with partial weight regain, indicating that neither strategy alone prevents long-term regain.

Expect some weight regain after losing weight, regardless of whether you exercised or not. This is a normal physiological response. To maximize long-term success, focus on strategies that limit this regain, as even the best current interventions (diet + exercise) only result in partial maintenance.

Long-term metformin use (up to 10 years) produces modest but durable weight loss and waist circumference reduction in overweight/obese individuals with impaired glucose tolerance, with effects directly proportional to adherence.

If you have prediabetes or are overweight with elevated blood sugar, metformin can help you lose a modest amount of weight (about 2% of body weight) and keep it off for years. This benefit is only realized if you take the medication consistently. Start with a low dose to minimize stomach upset, which usually goes away. The weight loss comes from fat, not muscle, and works alongside lifestyle changes like diet and exercise.

Maintaining intermittent restriction on just 1 day per week is sufficient to sustain the improvements in insulin resistance and body weight achieved during a 3-month intensive IECR phase.

After losing weight with a 2-days-a-week restriction plan, you can switch to just 1 restricted day per week to keep the weight off. On that one day, keep calories and carbs very low. On the other 6 days, eat a balanced, maintenance-level diet. This 'weekend warrior' approach helps maintain your health gains without the burden of daily dieting.

Very-low-calorie diets (VLCD, 400-800 kcal/d) under medical supervision produce approximately 20 kg of weight loss in 12-16 weeks, but long-term maintenance is poor without additional behavioral or exercise interventions.

VLCDs (400-800 kcal) can produce rapid weight loss (~20kg in 3-4 months) but require medical supervision. They are not a standalone long-term solution; combining them with behavior therapy or exercise significantly improves the chance of keeping the weight off.

Low-carbohydrate diets (defined as <20% energy or <40g CHO) produce significantly greater weight loss and triglyceride reduction, but also significantly increase LDL-cholesterol compared to low-fat diets in healthy adults over 6+ months.

If you switch to a low-carb diet (under 20% carbs or <40g/day) for at least 6 months, you will likely lose more weight and lower your triglycerides than if you followed a standard low-fat diet. However, be aware that your LDL cholesterol may rise. For healthy individuals, this trade-off is often acceptable, but those with existing heart disease or high LDL should monitor this closely or consult a doctor.

Low-carbohydrate diets significantly increase HDL-cholesterol levels compared to low-fat diets, although the clinical significance of this increase for cardiovascular risk reduction remains uncertain.

Low-carb diets tend to raise your HDL ('good') cholesterol more than low-fat diets do. However, don't assume this automatically protects your heart. Current evidence suggests that simply raising HDL doesn't necessarily lower heart disease risk, so focus on the bigger picture of weight management and overall lipid profile.