If you're trying to understand your options for obesity or weight loss, including after several approaches haven't been enough, you're in the right place.

That's a fair reason to be here.

Obesity: where each option sits in the evidence

This map shows obesity medicines, surgery and endoscopy, eating patterns, exercise, behavioral programs, and popular supplements as different kinds of decisions. A change in weight is not automatically the same as proven protection from heart attack, stroke, or death. The medicine that helps people lose the most weight is not automatically the one with heart-outcome evidence. Heart-outcome evidence from one medicine in people who already have heart disease does not cover every shot, and it does not cover everyone with obesity.

Use this map to understand the options and prepare better questions for your clinician. It isn't a guide to starting, stopping, or changing treatment on your own.

How to use this page

This is a landscape of what has been studied, not a prescription.

Obesity medicines stay on the map. Named diets, programs, and exercise are three different decisions. Surgery and endoscopy share a page because they are related procedure questions, not because they are the same treatment.

Open a topic that matches your question.

Check it.

Move to the next.

Bring what you learn to a clinician rather than changing treatment on your own.

Before you open a topic

A change in weight, waist, or body composition is not the same as proven protection from heart attack, stroke, or death.

Losing more weight is not the same ranking as heart-outcome evidence. Heart-outcome evidence from one medicine in people who already have heart disease does not cover every anti-obesity medicine, and it does not cover everyone with obesity.

Keep those distinctions in mind as you move through the map.

The evidence landscape

See the different roles these options play. Not a menu. A landscape.

Obesity medicines Weight-loss medicines. Heart-outcome evidence for one medicine in people who already have heart disease.
Surgery and endoscopy Two different procedure options on one page. Surgery has stronger long-term weight evidence.
Eating patterns Named diets compared for weight. Much of the difference fades by a year. Formula diets live here.
Exercise Modest average weight change. Separate jobs for fat, muscle, and fitness.
Behavioral weight-management programs Joining a program is not choosing a named diet.
Popular supplements What was studied. Small or not clinically important weight change. Not proven event prevention.

These are six decisions worth teaching, not six equal treatments.

What are you trying to figure out?

Find your question.

These are common decisions people face with obesity. The evidence isn't the same kind for every option. A change in weight is not the same as proven protection from heart attack, stroke, or death. Losing more weight is not the same ranking as heart-outcome evidence.

Obesity medicines

Weight-loss medicines. Heart-outcome evidence for one medicine in people who already have heart disease.

Do shots replace diet and surgery? Which medicine loses the most weight, and does that mean it protects the heart? Obesity medicines differ in how much weight they help people lose. Losing more weight is not the same as better evidence for preventing heart attacks. One medicine, semaglutide 2.4 mg, has heart-outcome evidence in people who already have heart disease, a BMI of 27 or higher, and no diabetes. That finding does not cover every shot, and it does not cover everyone with obesity. Older approved medicines stay in this conversation. Unregulated compounded pens are not the same as labeled medicines.

Surgery and endoscopy

Two different procedure options on one page. Surgery has stronger long-term weight evidence.

Is endoscopy a gentler surgery? Did shots replace operations? Does surgery prevent heart attacks? Surgery and endoscopy are two different procedure options. Endoscopy is not a gentler version of surgery. Some medicines looked similar to some operations at about one year. That does not retire long-term surgery, and it does not put shots and operations on one page. Long-term observational survival after surgery is not the same kind of evidence as a randomized heart-outcome trial of a medicine.

Eating patterns

Named diets compared for weight. Much of the difference fades by a year. Formula diets live here.

Which diet is best, and do the kilos last? Are formula or very-low-calorie diets a different decision? Does plant-based mean one plate? Low-carbohydrate and low-fat look similar at six months. Named-diet differences are small, and much of the weight loss fades by a year. Vegetarian eating is on the map. Those ranks are about weight and risk factors, not about who prevents heart attacks. Formula or very-low-calorie diets are a different protocol on this same page, not a diabetes-remission program.

Exercise

Modest average weight change. Separate jobs for fat, muscle, and fitness.

Does exercise even matter if the average is only a few kilograms? Which kind of training, and is that about heart attacks? Exercise usually changes average weight only a little, often not more than about 2 to 3 kg with aerobic training. It still has separate jobs: losing some fat, helping keep muscle while you lose weight, and improving fitness. That modest average is not a reason to ignore exercise, and it is not a rival to medicines.

Behavioral weight-management programs

Joining a program is not choosing a named diet.

Do commercial or clinic programs work, or does the weight just come back? Is joining a program the same as choosing a named diet? Behavioral weight-management programs are structured packages you join, not a named diet you pick from a chart. After a program ends, weight often comes back faster. People who joined a program can still weigh less than people who didn't, years later. Both parts of that finding matter. A page here does not mean programs sit beside medicines.

Popular supplements

What was studied. Small or not clinically important weight change. Not proven event prevention.

Do green tea, Garcinia, or “fat burners” replace care? Popular supplements such as green tea, Garcinia, and related “fat burner” products show small or not clinically important weight change in the reviews used here. They are not proven event prevention, and they do not replace indicated medicines or the food, activity, and program options above.

Evidence consulted Open sources

The eight-source library behind this map. Topic pages carry object-specific sources. Working evidence used on some topic pages is labeled there and is not a ninth library source. This is not a citation for every sentence.

Start with the question closest to yours.