Browse the evidence

Tirzepatide treatment (10 mg or 15 mg once weekly for 72 weeks) significantly improves self-reported health-related quality of life (HRQoL) in adults with obesity or overweight and type 2 diabetes, specifically in physical functioning, bodily pain, general health, vitality, and social functioning.

If you have type 2 diabetes and are overweight or obese, treatment with tirzepatide (Mounjaro/Zepbound) can significantly improve your daily quality of life. This includes feeling less pain, having more energy, and being more socially active. The improvements are seen in both physical and mental well-being, and they are greater for those who lose more weight. Talk to your doctor about whether this once-weekly injection is right for you, especially if you are struggling with physical limitations due to your weight.

Glucagon regulates glucose and amino acid homeostasis and counters hypoglycemia.

Glucagon is a natural hormone that helps keep your blood sugar and amino acid levels stable. It acts as a counter-regulatory mechanism to prevent hypoglycemia, making it essential for metabolic balance.

Lifestyle interventions (caloric restriction and exercise) are the foundation of MASLD treatment but often fail to achieve sufficient or sustained weight loss, necessitating pharmaceutical intervention.

Start with lifestyle changes: eat less and move more. This is the foundation of treating fatty liver. However, be realistic: it is very hard to maintain these changes long-term, and many people struggle to lose enough weight. If lifestyle changes are not enough, talk to your doctor about adding medications like GLP-1RAs or SGLT2-is, which can help you achieve the weight loss needed to improve your liver health.

GLP-1 receptor agonists (GLP-1RAs) such as liraglutide and semaglutide significantly reduce major adverse cardiovascular events (MACE) in patients with type 2 diabetes at high cardiovascular risk.

If you have Type 2 Diabetes and are at high risk for heart problems, ask your doctor about GLP-1 RAs like liraglutide or semaglutide. These drugs not only help control blood sugar but have been proven in major studies to significantly lower your risk of heart attack, stroke, and cardiovascular death. The benefits extend beyond glucose control to direct heart protection.

Obesity is a chronic disease driven by dysfunctional adipose tissue and dysregulated energy homeostasis, requiring medical treatment rather than solely lifestyle changes.

Obesity is a medical condition, not a moral failing. If you have obesity, you need medical treatment, not just willpower. Seek a doctor who understands this and offers evidence-based therapies.

Naltrexone/bupropion combination therapy produces moderate weight loss (up to 6.1% vs placebo) and improves metabolic markers, but carries risks of seizures and psychiatric side effects.

This medication can help you lose weight by affecting brain chemicals that control hunger. It is taken twice daily and must be started at a low dose to avoid side effects like nausea, constipation, or headaches. It is not suitable for people with a history of seizures, eating disorders, or heart problems. You must stop the medication if you do not lose at least 5% of your body weight after 12 weeks.

Current clinical guidelines recommend continuing GLP-1 receptor agonists for most patients undergoing elective surgery, shifting away from routine preoperative cessation.

Do not stop your GLP-1 medication before surgery unless your surgeon or anesthesiologist explicitly tells you to. Most modern guidelines now say you should keep taking it, and you should discuss your specific risk factors with them.

Metformin is the first-line pharmacological treatment for T2DM and prediabetes, offering significant reduction in microvascular complications and diabetes-related deaths through mechanisms including inhibition of hepatic gluconeogenesis and increased insulin sensitivity.

Metformin is the standard first-line drug for T2DM and prediabetes. It reduces complications and deaths. If you experience stomach upset, ask your doctor about slow-release versions or slow titration to manage side effects.

SGLT2 receptor inhibitors (SGLT2R-i) provide significant cardiovascular and renal benefits, including reduced cardiovascular mortality and heart failure hospitalization, in addition to glycaemic control, by preventing glucose reabsorption in the kidneys.

SGLT2 inhibitors (like empagliflozin or dapagliflozin) are powerful drugs for T2DM patients with heart or kidney risks. They significantly reduce heart failure hospitalizations and mortality. Maintain good hygiene to minimize the risk of genital infections.

Interval training (IT) and moderate intensity continuous training (MICT) produce equivalent changes in whole-body fat mass and lean mass when compared directly.

You do not need to train at high intensities to lose fat or build muscle. Moderate intensity continuous training (MICT) is just as effective as interval training (IT) for changing body composition. Choose the intensity you can sustain consistently, as the physiological outcome regarding fat and lean mass is essentially the same.

Obesity acts as an independent risk factor and driver for cardiovascular diseases through mechanisms including insulin resistance, endothelial dysfunction, systemic inflammation, and neurohormonal activation, leading to hypertension, heart failure, coronary artery disease, and stroke.

High body weight is a major biological driver of heart disease, not just a cosmetic issue. Addressing it requires medical and public health strategies, not just willpower, because it triggers harmful biological changes like inflammation and high blood pressure.

GLP-1 receptor agonists (e.g., semaglutide) and dual agonists (e.g., tirzepatide) are effective pharmacotherapies for obesity, achieving 10-20% mean body weight reduction, but their use is limited by stigma, regulatory barriers, and lack of insurance coverage.

If you have obesity, ask your doctor about GLP-1 receptor agonists (like semaglutide) or dual agonists (like tirzepatide). These are proven to help with significant weight loss. If insurance doesn't cover them, advocate for policy changes or look for patient assistance programs.

GLP-1 receptor agonists (GLP-1RAs) induce weight loss primarily through central nervous system (CNS) mechanisms, specifically by acting on GLP-1 receptors in the dorsal vagal complex (NTS and area postrema) and hypothalamic nuclei, rather than through peripheral signaling alone.

GLP-1 medications like semaglutide work by signaling to your brain to reduce hunger and food intake, not just by slowing digestion. Understanding this brain-gut connection helps explain why these drugs are effective for weight loss and why side effects like nausea occur via specific brain pathways.

For patients with Class II obesity (BMI 35-39.9 kg/m2), tirzepatide is significantly superior to other medications and endoscopic procedures, but its weight loss efficacy is inferior to major surgeries like Roux-en-Y gastric bypass (RYGB) and One-Anastomosis Gastric Bypass (OAGB).

If you have Class II obesity (BMI 35-39.9), surgery (like gastric bypass) will likely help you lose more weight than medication. However, if you are not ready for or cannot undergo surgery, newer medications like tirzepatide are still significantly more effective than other non-surgical options, though they will not achieve the same level of weight loss as surgery.

Once-weekly subcutaneous semaglutide at 2.4 mg significantly improves heart failure symptoms, exercise capacity, and quality of life in patients with heart failure with preserved ejection fraction (HFpEF) and obesity, independent of weight loss mechanisms.

For patients with HFpEF and obesity, once-weekly semaglutide (2.4 mg) significantly improves heart failure symptoms, exercise capacity, and quality of life. This treatment addresses a major unmet need in this population, offering benefits beyond weight loss alone. Patients should discuss this option with their healthcare provider, considering the potential for gastrointestinal side effects and the significant clinical improvements observed.

Lower grip strength is significantly associated with higher risks of all-cause mortality, cardiovascular disease mortality, respiratory disease mortality, and mortality from specific cancers (colorectal, lung, breast), independent of traditional risk factors.

Measure your grip strength regularly using a dynamometer. If your score is low (below sex-specific thresholds, e.g., <26 kg for men, <16 kg for women), it is a strong signal to review your overall health, including cardiovascular and metabolic markers, even if you feel healthy. Focus on building strength through resistance training, as higher grip strength is linked to lower mortality risk.

The association between lower grip strength and adverse health outcomes is stronger in younger age groups compared to older age groups.

If you are under 55 and have low grip strength, do not dismiss it as 'just being weak.' The risk associated with low strength is actually higher for you than for older adults. Prioritize strength training and medical check-ups.

SGLT2 inhibitors (specifically empagliflozin) reduce major adverse cardiovascular events (MACE) and cardiovascular death in patients with Type 2 Diabetes and established cardiovascular disease.

If you have Type 2 Diabetes and established cardiovascular disease, empagliflozin (10 or 25 mg daily) can significantly reduce your risk of major cardiovascular events and cardiovascular death. This benefit is observed even in patients with moderately reduced kidney function (eGFR > 30). The mechanism is likely related to hemodynamic changes rather than just glucose lowering.

GLP-1 receptor agonists (GLP-1RA) and Sodium-glucose cotransporter-2 inhibitors (SGLT2i) provide cardiovascular and renal benefits in T2D patients, whereas sulphonyureas are associated with increased cardiovascular mortality.

If you have Type 2 Diabetes and heart or kidney issues, ask your doctor about GLP-1RA or SGLT2i medications, as they protect your heart and kidneys. Avoid sulphonyureas if possible, as they may increase cardiovascular risk.

Excess body fat during childhood and adolescence causally increases the risk of developing Polycystic Ovary Syndrome (PCOS) in adulthood, independent of adult body size.

Maintaining healthy body composition during childhood and adolescence is critical for preventing PCOS later in life. Even if adult weight is normal, excess fat during youth leaves a lasting metabolic imprint (insulin resistance/low SHBG) that increases PCOS risk. Early lifestyle interventions are the most effective prevention strategy.

Adult obesity and overweight significantly increase the odds of PCOS, with adolescents showing even higher odds than adults for the same degree of adiposity.

Maintaining a healthy weight in adulthood reduces PCOS risk, but adolescent weight is even more critical. Adolescents with overweight or obesity face higher odds of developing PCOS than adults with the same conditions. Prioritize healthy weight management during teenage years.

Lifestyle interventions for obesity typically result in modest long-term weight loss (5-10%) and high rates of weight regain due to potent biological adaptations, specifically increased appetite and reduced energy expenditure.

If you lose weight through diet and exercise, expect your body to fight back with increased hunger and a slower metabolism. This is a normal biological response, not a failure of willpower. To maintain loss, you may need ongoing support or pharmacological intervention to counteract these specific hormonal signals.

Obesity results from a complex interaction between environmental factors (e.g., ultra-processed foods, reduced physical activity) and genetic susceptibility, rather than environmental factors alone.

Recognize that your genetics may predispose you to weight gain, but this does not mean you are powerless. Understanding this interaction can help you adopt more effective, personalized strategies for managing your weight, such as working with healthcare providers on targeted interventions.

Obesity significantly increases the risk of cardiovascular diseases (CVDs), including hypertension, coronary artery disease, heart failure, and arrhythmias, through mechanisms involving inflammation, endothelial dysfunction, and cardiac structural changes.

If you have obesity, you are at a significantly higher risk for heart disease, high blood pressure, and heart failure. This risk is driven by inflammation and structural changes in the heart. Weight loss through lifestyle changes is crucial for managing these risks. Regular screening for blood pressure, cholesterol, and heart function is recommended.