Browse the evidence

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.

Regular physical activity reduces the incidence of type 2 diabetes by improving insulin sensitivity and glucose uptake.

To prevent or manage type 2 diabetes, aim for at least 150 minutes of moderate exercise like brisk walking or biking each week. This can reduce your risk of developing diabetes by up to 40%. Combine this with a healthy diet and a goal of losing 7% of your body weight for the best results.

Regular physical activity reduces the risk of breast, colon, and prostate cancers and improves survival rates for these patients.

If you have breast, colon, or prostate cancer, regular physical activity can help reduce your risk of recurrence and improve your survival rates. It is safe during and after treatment and can help manage fatigue and improve your quality of life. Consult your oncology team for a personalized exercise plan.

Moderate (~10%) weight loss achieved through diet and exercise reduces pro-inflammatory M1-like macrophages in abdominal subcutaneous adipose tissue (SAT) in adults with adult-onset obesity (AO), but fails to alter these immune cell profiles in those with childhood-onset obesity (CO).

If you developed obesity as an adult, moderate weight loss (around 10%) through diet and exercise may help reduce inflammation in your abdominal fat. However, if you have been obese since childhood, the same level of weight loss might not change the inflammatory state of your fat tissue, even if you lose weight and improve blood markers like insulin. This suggests that long-term obesity history creates a 'memory' in fat tissue that is harder to reverse with standard lifestyle changes alone.

Moderate weight loss increases CD3+CD4+ T cells in both abdominal and femoral subcutaneous adipose tissue in adults with adult-onset obesity (AO), but not in those with childhood-onset obesity (CO).

If you developed obesity as an adult, moderate weight loss may trigger an increase in CD4+ T cells in your fat tissue, which could include regulatory T cells that help manage inflammation. If you have been obese since childhood, this specific immune shift may not occur with the same degree of weight loss. This highlights that long-term obesity history creates a 'memory' in fat tissue that is harder to reverse with standard lifestyle changes alone.

Moderate (~10%) weight loss improves systemic cardiometabolic risk factors (plasma insulin and arterial stiffness) similarly in both childhood-onset (CO) and adult-onset obesity (AO) populations.

Losing about 10% of your body weight through diet and exercise significantly improves your blood vessel health (arterial stiffness) and insulin sensitivity, regardless of whether you became obese as a child or as an adult. This is a robust benefit of weight loss that applies to everyone with obesity.

Post-operative nutritional counseling has a lasting 'eye-opening' effect on patient habits, reducing the perceived need for further nutritional education compared to other support areas.

Take the initial nutritional counseling before your surgery seriously. For most patients, this 'eye-opening' session provides enough knowledge to manage diet long-term without needing constant follow-up. Focus your energy on the physical activity aspect, where ongoing support is more critical.

A behavioral weight loss maintenance intervention provides a clinically meaningful but statistically non-significant weight advantage (approx. 3 kg) over usual care for up to two years after the active intervention period ends.

This study suggests that learning weight maintenance skills during a structured program can help you keep weight off for at least two years after the program ends, even if you stop seeing the coach. While the statistical proof isn't perfect due to real-world data variability, the average benefit was about 3kg (6.6 lbs) compared to doing nothing. The key is transitioning from coach-led support to self-managed maintenance skills.

Dietary interventions that modulate gut microbiota composition (specifically increasing SCFA-producing bacteria and reducing dysbiosis) improve metabolic health outcomes including insulin sensitivity and glucose tolerance.

To improve your metabolic health, focus on dietary patterns that support a diverse gut microbiome. This means consuming a variety of plant fibers (prebiotics) to encourage the growth of beneficial bacteria that produce short-chain fatty acids (SCFAs). These SCFAs help regulate blood sugar and insulin sensitivity. Avoid highly processed foods that can cause dysbiosis (microbial imbalance) and inflammation.