Browse the evidence

Pharmacological weight loss agents (GLP-1 agonists, etc.) should be used as adjuncts to lifestyle changes in older adults only after careful case-by-case assessment of sarcopenia risk and limited clinical data.

If lifestyle changes aren't enough, discuss prescription options like GLP-1 agonists with your doctor. Be aware that data for those over 75 is scarce, and these drugs can affect muscle mass, so they must be paired with strength training and protein intake.

Metabolic and bariatric surgery (MBS) provides significantly greater reduction in major adverse cardiovascular events (MACE) and all-cause mortality compared to GLP-1 receptor agonist (GLP-1 RA) therapy in patients with obesity and type 2 diabetes.

If you have obesity and type 2 diabetes, metabolic surgery (like gastric bypass or sleeve gastrectomy) is currently shown to be more effective than GLP-1 medications (like semaglutide or liraglutide) at preventing heart attacks, strokes, and death. While GLP-1 drugs are important for those who cannot have surgery, surgery offers greater long-term cardiovascular protection and more sustained weight loss, though it carries surgical risks and requires lifelong nutritional monitoring.

Interdisciplinary Cognitive-Behavioral Therapy (IT+CBT) effectively supports weight loss and improves quality of life in adults with obesity.

Interdisciplinary Cognitive-Behavioral Therapy (IT+CBT) combines goal setting, impulse control, and problem-solving with cognitive strategies to help patients achieve and maintain weight loss. A small study showed it was superior to health education or physical exercise alone. It requires commitment to therapy sessions.

GLP-1 based therapies (Retatrutide, Ebenatide) cause significant muscle mass loss at higher doses, whereas lower doses or standard GLP-1 agonists preserve muscle mass better.

If you are using high-dose GLP-1 based therapies (like Retatrutide 8-12mg), be aware that you may lose more muscle than with lower doses or standard GLP-1s. This is a trade-off for greater fat loss. Prioritize protein intake and resistance training to protect your muscle mass, especially if you are older.

GLP-1 receptor agonists reduce albuminuria and slow eGFR decline in non-diabetic patients with CKD, particularly those who are obese.

If you have kidney disease and are obese but do not have diabetes, ask your doctor about GLP-1 receptor agonists like semaglutide. Early evidence suggests these medications can significantly reduce albuminuria, a marker of kidney damage, even in non-diabetic patients. However, more research is needed to confirm long-term kidney outcomes in this group.

Preoperative GLP-1 RA therapy (4–8 weeks) reduces liver volume and visceral fat to improve surgical access, provided treatment is discontinued 1 week prior to surgery to mitigate aspiration risk.

If you are scheduled for bariatric surgery and take GLP-1 medications (like Ozempic or Wegovy), you must stop taking them at least one week before your operation. This is not optional; it is a safety requirement to prevent stomach contents from entering your lungs during anesthesia. The goal of this pre-surgery treatment is to shrink your liver and make the surgery technically easier and safer for the surgeon, not necessarily to prevent surgical complications like leaks.

Tirzepatide use in patients at increased risk of cardiovascular events does not increase the risk of serious adverse events or all-cause mortality compared to placebo, but significantly increases the risk of gastrointestinal non-serious adverse events.

If you are at high risk for heart issues, tirzepatide appears safe regarding serious complications like death or hospitalization, but you should expect stomach problems like nausea and diarrhea. These are common but usually not dangerous. Talk to your doctor about starting at a low dose to minimize these effects.

Microbiome-targeted interventions like prebiotics, probiotics, and synbiotics show potential antihypertensive effects, but results are heterogeneous and require larger randomized trials.

While probiotics and prebiotics show promise, they are not yet a proven standalone treatment for hypertension. Focus on a healthy diet and lifestyle first, and consider these supplements as potential adjuncts under medical guidance.

Combining different weight-lowering drugs with complementary mechanisms (e.g., GLP-1 RA with activin receptor antagonist) can enhance weight loss and preserve lean body mass, potentially offering superior cardiovascular protection compared to monotherapy.

For some patients, taking a single weight-loss drug might lead to muscle loss, which isn't ideal for heart health. New combination therapies, such as pairing a GLP-1 drug with a muscle-preserving agent, are being developed to prevent this. These combinations can lead to greater fat loss and better preservation of muscle mass, which is crucial for metabolic health. While these are still emerging, they represent a promising approach for those who struggle with muscle loss on standard treatments.

GLP-1/GIP agonists do not increase overall cancer risk and may reduce incidence of obesity-related cancers (endometrial, ovarian, gastrointestinal) via metabolic improvements, though organ-specific long-term safety remains uncertain.

GLP-1/GIP therapies are not associated with a general increase in cancer risk and may lower risk for obesity-related cancers. However, long-term organ-specific effects are not fully known, so standard cancer screening remains essential.

CJC-1295 and Ipamorelin restore youthful growth hormone secretion patterns by preserving physiological pulsatility, avoiding the adverse effects of continuous exogenous GH administration.

CJC-1295 and Ipamorelin are peptides that stimulate natural growth hormone pulses, potentially reversing age-related muscle loss and fat gain. While they show promise in restoring youthful GH patterns, they are not FDA-approved for anti-aging, and long-term safety data is lacking.

Treatment with tirzepatide is associated with numerically lower impairment in health-related quality of life (HRQoL) domains and work productivity compared to non-pharmacological management or other obesity medications in real-world settings.

If you are managing obesity with tirzepatide, you may experience better daily functioning and work productivity compared to managing it without medication, although individual results vary. This medication is typically taken once weekly alongside diet and exercise. Real-world data suggests these benefits are most pronounced when combined with weight loss.

Orlistat, a pancreatic lipase inhibitor, promotes modest weight loss and improves gut microbiota diversity (increasing Akkermansia and Verrucomicrobia), but its efficacy is significantly lower than GLP-1 agonists.

Orlistat blocks fat absorption, leading to modest weight loss and improved gut bacteria diversity. However, it is significantly less effective than GLP-1 agonists. Side effects like bloating and diarrhea are common if dietary fat is not strictly limited.

Small-molecule oral GLP-1 receptor agonists (e.g., orforglipron) achieve glycemic and weight loss efficacy approaching that of established injectable peptide GLP-1RAs, offering a non-injectable alternative with comparable metabolic benefits.

If you struggle with injections or cold-chain storage, ask your doctor about oral small-molecule GLP-1RAs (like orforglipron). Recent trials show they can lower blood sugar and reduce weight significantly, often approaching the results of injectable drugs. Because they are taken daily, consistency is key, and starting with a low dose to manage stomach side effects is standard practice.

73% of adults with diabetes received advice from health professionals to exercise more compared to 31% of adults without diabetes.

Health professionals are actively advising patients with diabetes to increase exercise.

The likelihood of receiving exercise advice increased with the number of diabetes risk factors.

Encouraging exercise advice may be more effective for individuals with multiple risk factors.

Tirzepatide treatment duration is positively correlated with cumulative cardio-metabolic-kidney (CKM) benefits, with patients persisting on therapy for >1 year achieving significantly greater weight loss, lipid improvements, and hepatic/renal marker reductions compared to short-term users.

If you are using tirzepatide for obesity, sticking with it beyond the first year is critical. The data shows that patients who persist for more than a year lose significantly more weight and see greater improvements in heart, liver, and kidney markers than those who stop early. To maximize these benefits, work with your provider to manage side effects and ensure you have the support and resources to stay on the medication long-term.

49% of Colorado firefighters do not meet the minimum recommended VO2 max of 42.0 ml/kg/min.

Improving cardiorespiratory fitness is essential for firefighter health and safety.

VO2 max is negatively associated with abnormal MetS components, with an incident rate ratio of 0.95.

Enhancing VO2 max may reduce the risk of metabolic syndrome in firefighters.

Spontaneous physical activity is inversely related to body weight.

Encouraging spontaneous physical activity may help in body weight management.

68.9% of plastic surgeons believe GLP-1 agonists are effective for weight loss.

A large majority of plastic surgeons recognize the weight loss effectiveness of GLP-1 agonists.

Subjects in the highest tertile of the healthy dietary pattern have a lower risk of MetS compared to those in the lowest tertile.

Encouraging a healthy dietary pattern may reduce the risk of MetS in this population.

Stacking supplements can be a deliberate strategy to maximize results in athletes.

Athletes may consider strategic stacking of supplements to enhance performance.

Combining creatine with β-alanine can delay fatigue.

Athletes may benefit from combining creatine and β-alanine for improved endurance.