> ## Content Index > Fetch the complete content index at: https://elonmuscular.com/llms.txt > Use this file to discover other available public pages before exploring further. # Earn Your Abs - URL: https://elonmuscular.com/protocol-visible-abs/ - Published: 2026-09-27T17:19:52.000Z - Updated: 2026-10-12T07:29:26.000Z - Description: Tracks the weekly average weight, falling 0.5 to 1% a week, read with the tape and the photos. 42 moves, every one with its trial. - Author: Elon Muscular - Tags: Metabolism, Protocol [The library](https://elonmuscular.com/library/) / Metabolism # Earn Your Abs Lose belly fat Also called Getting visible abs, Six pack, Visible abs, Cutting 5 min plan125 min with every studyUpdated Sep 28, 2026 Who it's forA man who wants visible abs: lean enough for the six-pack to show, with his muscle kept. [Plan](#pr2-plan)[Track](#pr2-track)[Studies](#pr2-studies) Your number The weekly average weight, falling 0.5 to 1% a week, read with the tape and the photos Weigh daily, average weekly. Judge at 12. On this page [This week](#pr2-tonight)[The plan](#pr2-plan)[How you'll know](#pr2-know)[Why this happens](#pr2-why)[Week by week](#pr2-week)[What to track](#pr2-track)[Doses at a glance](#pr2-doses)[Deep dives](#pr2-deep)[The studies](#pr2-studies)[Words on this page](#pr2-words) ## This week 1. Photos, tape, and a weigh-in every morning 2. Three or four lifting days, heavy, every muscle twice 3. Protein: your weight in pounds (kilos times 2.2), in grams 4. Eat a little less: aim for 0.5 to 1% a week 5. Walk toward 8,500 steps a day 6. Seven to nine hours asleep ## The plan Abs show on the way down17.5%13.8%7.4%4.5%stage lean **Figure 1.** The range you are cutting into. Tracked long cuts started at 13.8 to 17.5% body fat and reached stage lean at 4.5 to 7.4%. The abs come into view on the way down, well before the bottom; the photos judge where, not a chart. 42 moves, in order, after 11 checks. Tap any row to see how. ### Check first The target: how lean is lean enoughAbs show on the way down; stage lean is 4.5 to 7.4%Check ### The target: how lean is lean enough For: Everyone cutting Visible abs come on the way down to very lean. Stage-lean is about 4.5 to 7.4% body fat, and you do not need to go that far. #### How to check 1. Take photos now; they are how you judge the range. 2. Cut until the abs show in the photos. 3. Stop there. The last few percent take a toll on your hormones and strength. What it is Down to where abs show When Judge on the photos How often The whole cut Reading the number 4.5to 7.4% is stage lean Tracked long cuts went from about 14 to 17.5% body fat down to 4.5 to 7.4%. Abs show well before the bottom. ¹ International journal of sport nutrition and exercise metabolism, 2014\. The study is under The science, below. Watch out At stage lean, testosterone, strength and mood all dropped. Stop earlier. The science In detail This is the range you are cutting into. Long cuts tracked all the way to stage lean started at about 13.8 to 17.5% body fat and finished at 4.5 to 7.4%. Abs come into view on the way down that range, well before the bottom. The stage end is a peak held for a day, not a place to live: take it off the table. Found **Stage lean was 4.5 to 7.4%.** Three tracked long cuts: 17.5% down to 7.4% by DEXA, 13.8% down to 5.1% by DEXA, and 14.8% down to 4.5%. At the bottom, testosterone and strength fell. Testosterone came back as body fat returned to about 14%; strength had not fully recovered 6 months later. Why The abs are there already. What hides them is the layer of fat over them, and it thins as your total body fat falls. How far down you need to go depends on how thick the muscle is and where you store fat. That is why the photos and the tape judge it, not a chart. Watch The last few percent take the most out of you: hormones, strength, mood and sleep all dropped at stage lean. Stop at the point your abs show and you still feel well. How it is done Abs show above stage lean; Judged on the photos; Across the whole cut The doses the studies used**7.4%** *stage lean, the first cut* 17.5%13.8%7.4%4.5% percent body fat (17.5 to 7.4%) [PMID 24901578](https://pubmed.ncbi.nlm.nih.gov/24901578/?ref=elonmuscular.com) #### The studies Body weight (88.6 to 73.3 Kg, R(2) = .99) and percent body fat (17.5 to 7.4%) were reduced during preparation. [PMID 24901578](https://pubmed.ncbi.nlm.nih.gov/24901578/?ref=elonmuscular.com) · Case study: Natural bodybuilding contest preparation. · International journal of sport nutrition and exercise metabolism, 2014 The sentence around it Body weight (88.6 to 73.3 Kg, R(2) = .99) and percent body fat (17.5 to 7.4%) were reduced during preparation. Percent body fat declined from 14.8% to 4.5% during preparation and returned to 14.6% during recovery. [PMID 23412685](https://pubmed.ncbi.nlm.nih.gov/23412685/?ref=elonmuscular.com) · Natural bodybuilding competition preparation and recovery: a 12-month case study. · International journal of sports physiology and performance, 2013 The sentence around it Percent body fat declined from 14.8% to 4.5% during preparation and returned to 14.6% during recovery. The scale: weekly average weightWeigh daily, average weeklyCheck ### The scale: weekly average weight For: Everyone cutting Weigh every morning and average the week. It tells you if the cut is going at the right speed. #### How to check 1. Weigh every morning, after using the bathroom, before food. 2. Average the 7 days. 3. Losing over 1% a week? Eat a little more. What it is One weigh-in a day When Every morning How often Every week Standard practice Check how you are getting on by weighing yourself regularly. Reading the number 0.5to 1% a week The reviews set the pace at 0.5 to 1% of body weight a week, to keep the most muscle. ¹ Nutrients, 2021\. The study is under The science, below. The science In detail Weigh every morning after using the bathroom and before food, and average the week. The average tells you the pace: aim for 0.5 to 1% of body weight a week, the slow end as you get leaner. Found Two reviews of fat-loss phases: set the calories so body weight falls 0.5 to 1% a week, to keep the most muscle. Why One morning's weight swings with water, salt and food in the gut. A week's average shows what the deficit is really doing. How it is done Every morning, averaged weekly; After using the bathroom, before food; Every week #### The studies Caloric intake should be set based on a target BW loss of 0.5-1.0%/week to maximize fat-free mass retention. [PMID 34579132](https://pubmed.ncbi.nlm.nih.gov/34579132/?ref=elonmuscular.com) · Achieving an Optimal Fat Loss Phase in Resistance-Trained Athletes: A Narrative Review. · Nutrients, 2021 The sentence around it Caloric intake should be set based on a target BW loss of 0.5-1.0%/week to maximize fat-free mass retention. Caloric intake should be set at a level that results in bodyweight losses of approximately 0.5 to 1%/wk to maximize muscle retention. [PMID 24864135](https://pubmed.ncbi.nlm.nih.gov/24864135/?ref=elonmuscular.com) · Evidence-based recommendations for natural bodybuilding contest preparation: nutrition and supplementation. · Journal of the International Society of Sports Nutrition, 2014 The sentence around it Caloric intake should be set at a level that results in bodyweight losses of approximately 0.5 to 1%/wk to maximize muscle retention. The tape: your waistThe waist every week, at the belly buttonCheck ### The tape: your waist For: Everyone A tape round your belly shows the fat coming off the exact place you care about. #### How to check 1. Tape at the belly button, relaxed, after breathing out. 2. Same time of day, once a week. 3. Aim for well under half your height. What it is One measurement When Same time of day How often Every week Standard practice Keep your waist to less than half your height. Reading the number Waist down, lifts held The consensus says exercise and diet bring the waist down by an amount that matters. ¹ Nature reviews. Endocrinology, 2020\. The study is under The science, below. The science In detail Tape the waist at the belly button, relaxed, after breathing out, at the same time of day, every week. The waist falling while the lifts hold means the loss is fat. Aim to get it well under half your height. Found **Waist under half your height.** The experts' joint statement on waist size: routine moderate exercise and diet bring the waist down by an amount that matters for health. Why The belly is where the fat that hides the abs sits, so the tape tracks it directly. How it is done Tape at the belly button; Same time of day, after breathing out; Every week #### The study Moreover, we describe evidence that clinically relevant reductions in waist circumference can be achieved by routine, moderate-intensity exercise and/or dietary interventions. [PMID 32020062](https://pubmed.ncbi.nlm.nih.gov/32020062/?ref=elonmuscular.com) · Waist circumference as a vital sign in clinical practice: a Consensus Statement from the IAS and ICCR Working Group on Visceral Obesity. · Nature reviews. Endocrinology, 2020 The sentence around it Moreover, we describe evidence that clinically relevant reductions in waist circumference can be achieved by routine, moderate-intensity exercise and/or dietary interventions. The photos: same light, same spotThree photos a week, taken the same wayCheck ### The photos: same light, same spot For: Everyone Photos taken the same way each week show the abs arriving better than the mirror does. #### How to check 1. Front, side and back, relaxed then flexed. 2. Same light, spot, shorts and time of day. 3. Once a week; compare with the first set. What it is Three photos When First thing in the morning How often Every week Reading the number Photos matched the scan Body fat read from photos agreed closely with a DEXA scan, better than the other home methods. ¹ NPJ digital medicine, 2025\. The study is under The science, below. The science In detail Front, side and back, relaxed and then flexed, in the same light, the same spot and the same shorts, first thing in the morning, every week. Compare with the first set, never with yesterday. Found A large study: body fat estimated from 2D photos agreed with a DEXA scan better than any other field method tested. A phone app gave near-identical readings when repeated under the same conditions. Why The mirror changes with the light and your mood. Photos taken the same way are the fairest judge of when the abs have arrived. Watch Checking the mirror many times a day, or never feeling lean enough, is a sign to talk to someone. See the body-image check. How it is done Front, side and back; Same light, spot and time; Every week #### The studies AI-2D photos demonstrated substantial agreement with DXA presenting the highest agreement (CCC ≥ 0.96) among all the investigated methods. [PMID 39827323](https://pubmed.ncbi.nlm.nih.gov/39827323/?ref=elonmuscular.com) · Advances in the estimation of body fat percentage using an artificial intelligence 2D-photo method. · NPJ digital medicine, 2025 The sentence around it AI-2D photos demonstrated substantial agreement with DXA presenting the highest agreement (CCC ≥ 0.96) among all the investigated methods. All methods showed excellent within session repeatability under standardized conditions (ICC > 0.99). [PMID 42685095](https://pubmed.ncbi.nlm.nih.gov/42685095/?ref=elonmuscular.com) · Assessing body composition via a smartphone computer vision application: High repeatability but method-dependent agreement compared with BODPOD and Inbody. · PLOS digital health, 2026 The sentence around it All methods showed excellent within session repeatability under standardized conditions (ICC > 0.99). The log: your lifts should holdLog every set; the lifts should holdCheck ### The log: your lifts should hold For: Everyone lifting Log every set. If your lifts hold while your waist shrinks, you are losing fat, not muscle. #### How to check 1. Log each exercise, weight and reps. 2. Try to match or beat the log each week. 3. Lifts falling 2 weeks running? Eat a little more and sleep more. What it is Every set When Every session How often For good Reading the number Strength kept On 40% less food with high protein, every measure of performance still improved. ¹ The American journal of clinical nutrition, 2016\. The study is under The science, below. The science In detail Write down every set: the exercise, the weight, the reps. On a cut at the right pace the lifts should hold, and a newer lifter's can still climb. Lifts falling two weeks running mean the cut is too fast or the sleep too short. Found **Strength kept in a deficit.** A review of lifting in a deficit: strength gains were comparable to lifting at maintenance. On 40% less food with high protein, every measure of performance improved. Why Strength is the quickest sign the muscle is staying. The abs look best on a body that kept its muscle. How it is done Every set, written down; Every session; Judge it every 2 weeks #### The studies All measures of exercise performance improved similarly in the PRO and CON groups as a result of the intervention [PMID 26817506](https://pubmed.ncbi.nlm.nih.gov/26817506/?ref=elonmuscular.com) · Higher compared with lower dietary protein during an energy deficit combined with intense exercise promotes greater lean mass gain and fat mass loss: a randomized trial. · The American journal of clinical nutrition, 2016 The sentence around it All measures of exercise performance improved similarly in the PRO and CON groups as a result of the intervention When training at a specific RM load, it is recommended that 2-10% increase in load be applied when the individual can perform the current workload for one to two repetitions over the desired number. [PMID 19204579](https://pubmed.ncbi.nlm.nih.gov/19204579/?ref=elonmuscular.com) · American College of Sports Medicine position stand. Progression models in resistance training for healthy adults. · Medicine and science in sports and exercise, 2009 The sentence around it When training at a specific RM load, it is recommended that 2-10% increase in load be applied when the individual can perform the current workload for one to two repetitions over the desired number. When to stop: too little fuelSex drive gone, cold, dizzy, lifts sliding: stop the cutCheck ### When to stop: too little fuel For: Everyone cutting If your sex drive disappears, you feel cold and dizzy, and your lifts drop, you are not eating enough. Stop cutting and eat more. #### How to check 1. Every week, ask: sex drive, morning erections, cold, dizzy, sleep, lifts. 2. Two or more? Eat at maintenance for 2 weeks. 3. Still there after 2 weeks? See your doctor and ask for bloods. What it is One check When Every week How often The whole cut Reading the number Low sex drive: stop Low sex drive was the one sign that picked out those running too low on fuel. On one long cut, testosterone fell from 623 to 173 ng/dL. ¹ Nutrients, 2022\. The study is under The science, below. Watch out Left running, it can thin your bones and affect fertility. The science In detail Sex drive gone, morning erections rare, always cold, dizzy when you stand, ill more often, sleep broken, lifts sliding, mood flat: the fuel is too low. Stop the cut, eat at maintenance, and see your doctor if it does not lift within 2 weeks. Keep food above about 30 calories per kilo of lean mass a day, after the calories training burns. Found **Low sex drive is the first flag.** A screening study for low energy availability: only low sex drive told the cases from the rest, and it tracked the clinical markers. One long cut, tracked month by month: testosterone fell from 623 to 173 ng/dL and thyroid hormone fell with it. Expert guidance keeps energy availability above 30 calories per kilo of lean mass. Why Eat too little for the training and the body cuts what it can spare: sex hormones, thyroid hormone, bone building and recovery. Sport medicine calls it low energy availability, and the syndrome it causes RED-S. It comes back with food. Watch Left running, it brings low bone density, stress fractures and infertility. Food and eating taking over: see your doctor soon. How it is done Energy above 30 calories per kg lean mass; Check every week; Stop the cut at the first signs #### The studies only low sex drive was able to distinguish between LEA cases and controls and was associated with perturbations in key clinical markers and questionnaire responses. [PMID 35565840](https://pubmed.ncbi.nlm.nih.gov/35565840/?ref=elonmuscular.com) · Screening for Low Energy Availability in Male Athletes: Attempted Validation of LEAM-Q. · Nutrients, 2022 The sentence around it only low sex drive was able to distinguish between LEA cases and controls and was associated with perturbations in key clinical markers and questionnaire responses. From M1 to M8, testosterone (623-173 ng∙dL -1 ), T 3 (123-40 ng∙dL -1 ), and T 4 (5.8-4.1 mg∙dL -1 ) decreased [PMID 28770669](https://pubmed.ncbi.nlm.nih.gov/28770669/?ref=elonmuscular.com) · Case Study: Unfavorable But Transient Physiological Changes During Contest Preparation in a Drug-Free Male Bodybuilder. · International journal of sport nutrition and exercise metabolism, 2017 The sentence around it From M1 to M8, testosterone (623-173 ng∙dL -1 ), T 3 (123-40 ng∙dL -1 ), and T 4 (5.8-4.1 mg∙dL -1 ) decreased, while cortisol (25.2-26.5 mg∙dL -1 ) and ghrelin (383-822 pg∙mL -1 ) increased.… Mood, food and body imageBingeing, too little food or body worry: your doctorCheck ### Mood, food and body image For: Everyone cutting Strict dieting can tip into bingeing or an eating problem. Worrying about your body all day needs a doctor. #### How to check 1. Bingeing after strict days, or eating very little? See your doctor. 2. Never lean enough, whatever the photos say? See your doctor. What it is One check When Any time How often Every month Standard practice Eating too much or too little, or worrying about your weight or shape, can be an eating disorder. See your doctor as soon as you can. Reading the number Get help early The review warns that repeated dieting may drive binge eating, and constant checking may feed body worry. ¹ Sports (Basel, Switzerland), 2019\. The study is under The science, below. The science In detail Bingeing after a strict week, eating very little, or burning off food with extra exercise: see your doctor soon. The same if you think about your weight or shape much of the day. So is never feeling lean enough, whatever the photos show. Found **Bingeing or body worry: your doctor.** A review of lean-physique nutrition: the drive that comes with repeated dieting may lead to binge eating. Judging your physique over and over may feed body image worry. The answer it gives: flexible dieting, slower loss and support close by. Why A cut runs on restraint, and restraint can tip into a problem. Caught early, eating and body image problems respond well to treatment. How it is done An honest look at the habit; Any time; Every month of the cut #### The study However, the biological drive of cyclical energy restriction may contribute to binge-eating behavior. [PMID 31315180](https://pubmed.ncbi.nlm.nih.gov/31315180/?ref=elonmuscular.com) · Towards a Sustainable Nutrition Paradigm in Physique Sport: A Narrative Review. · Sports (Basel, Switzerland), 2019 The sentence around it However, the biological drive of cyclical energy restriction may contribute to binge-eating behavior. Additionally, requisite monitoring, manipulation, comparison, and judgement of one's physique may contribute to body image concerns. The sentence around it Additionally, requisite monitoring, manipulation, comparison, and judgement of one's physique may contribute to body image concerns. Never cut water or take water pillsNo water cuts, no diuretics, no laxativesCheck ### Never cut water or take water pills For: Everyone Never cut water or take water pills to look leaner. They can drop your potassium to a level that stops the heart. #### How to check 1. Drink normally, every day of the cut. 2. No diuretics, no laxatives, no water tricks. 3. Dizzy, cramping or a racing heart after one? 911 if severe. What it is None When Never How often Never Reading the number Potentially life-threatening Very low potassium, which water pills can cause, is potentially life-threatening. Cutting water before a shoot can be dangerous. ¹ Journal of the International Society of Sports Nutrition, 2014\. The study is under The science, below. Watch out Laxatives or water pills to control weight are a sign of an eating problem too. See your doctor. The science In detail Never drop water, sweat it out, or take diuretics, laxatives or "water pills" to look sharper. Collapse, chest pain or breathing trouble: 911. Found **Low potassium can kill.** The contest-prep review: dehydration and electrolyte manipulation in the final days can be dangerous. A case report: severe low potassium is potentially life-threatening, and diuretics are a known cause. The kidney review: dehydrating practices and diuretic misuse carry risks. Why Water pills pull potassium and sodium out with the water. Muscles, the heart included, need both to fire, which is how a water cut ends in cramps, weakness, collapse or a heart rhythm problem. Watch Using laxatives or diuretics to control weight is also a sign of an eating disorder. See the body-image check. How it is done None.; Never.; Never. #### The studies The practice of dehydration and electrolyte manipulation in the final days and hours prior to competition can be dangerous [PMID 24864135](https://pubmed.ncbi.nlm.nih.gov/24864135/?ref=elonmuscular.com) · Evidence-based recommendations for natural bodybuilding contest preparation: nutrition and supplementation. · Journal of the International Society of Sports Nutrition, 2014 The sentence around it The practice of dehydration and electrolyte manipulation in the final days and hours prior to competition can be dangerous Severe hypokalemia is a potentially life-threatening disorder and is associated with variable degrees of skeletal muscle weakness, even to the point of paralysis. [PMID 21871759](https://pubmed.ncbi.nlm.nih.gov/21871759/?ref=elonmuscular.com) · Hypokalemic paralysis in a professional bodybuilder. · The American journal of emergency medicine, 2012 The sentence around it Severe hypokalemia is a potentially life-threatening disorder and is associated with variable degrees of skeletal muscle weakness, even to the point of paralysis. Rule out what holds the fat onStuck despite doing it right: thyroid, cortisol, medicinesCheck ### Rule out what holds the fat on For: Stuck despite the plan If nothing moves after a month of doing it right, a medicine or a hormone problem may be the cause. Your doctor can check. #### How to check 1. A month of the plan and the average has not moved? See your doctor. 2. Tired, cold and gaining? Ask for a thyroid test. 3. Take a list of every medicine you take. What it is One check When If stuck for a month How often Once Standard practice Your doctor can help if a thyroid problem, Cushing's syndrome or a medicine makes weight harder to manage. Reading the number Rule it out Many medicines add weight, steroid tablets and some antidepressants among them. Thyroid and hormone problems add fat. ¹ Annals of the New York Academy of Sciences, 2024\. The study is under The science, below. Watch out Never stop a prescribed medicine yourself. Ask the doctor who prescribed it. The science In detail If the weekly average will not move after a month of doing it all right, look for a cause. Tired, cold, gaining weight and constipated: ask your doctor for a thyroid blood test. Fat gathering on the belly, neck and upper back with thin arms and legs, easy bruising and stretch marks: ask about cortisol. Take a list of every medicine you use. Found **Thyroid, cortisol, medicines.** A review of medicines that add weight: antipsychotics, steroid tablets, beta blockers, some antidepressants, antihistamines, insulin and sleep drugs among them. A second review: an underactive thyroid, low testosterone and Cushing's syndrome reproduce the same pattern of more fat and less muscle. Why Hormones decide where the energy goes. Too little thyroid hormone or testosterone, or too much cortisol, tips the body toward storing fat. Treated at the cause, the cut works again. Watch Never stop a prescribed medicine on your own. Ask the doctor who prescribed it about the weight. How it is done One visit, one list; When a month of the plan moves nothing; Once #### The studies Many medication classes are implicated in the pharmacologic causes of weight gain, including antipsychotics, glucocorticoids, beta-adrenergic blockers, tricyclic antidepressants, antihistamines, insulin, neuropathic agents, sleep agents, and steroids. [PMID 38385953](https://pubmed.ncbi.nlm.nih.gov/38385953/?ref=elonmuscular.com) · Pharmacotherapy causing weight gain and metabolic alteration in those with obesity and obesity-related conditions: A review. · Annals of the New York Academy of Sciences, 2024 The sentence around it Many medication classes are implicated in the pharmacologic causes of weight gain, including antipsychotics, glucocorticoids, beta-adrenergic blockers, tricyclic antidepressants, antihistamines, insulin, neuropathic agents, sleep agents, and steroids. endocrine diseases such as hypogonadism, GH deficiency, hypothyroidism, Cushing syndrome, hyperaldosteronism, and diabetes replicate many features of SO [PMID 41649890](https://pubmed.ncbi.nlm.nih.gov/41649890/?ref=elonmuscular.com) · Endocrinological aspects of sarcopenic obesity. · Annals of medicine, 2026 The sentence around it …Beyond aging, endocrine diseases such as hypogonadism, GH deficiency, hypothyroidism, Cushing syndrome, hyperaldosteronism, and diabetes replicate many features of SO and serve as valuable models for investigating its underlying mechanisms.… Steroids and fat-loss drugs: tell the doctorPast or present steroid use: tell the doctorCheck ### Steroids and fat-loss drugs: tell the doctor For: Anyone who has used Steroids shut down your own testosterone, sometimes for years, and damage the heart. Tell your doctor if you have used them. #### How to check 1. Tell the doctor everything you take, steroids included. 2. Low mood after stopping: see your doctor. What it is One honest list When At the first visit How often Once Standard practice Regular anabolic steroid use can cause infertility, shrunken testicles, erectile dysfunction, heart attack or stroke, liver or kidney failure, and aggression. They are addictive. See your doctor. Reading the number Low testosterone for years Years after stopping, former users had lower testosterone than those who never used. Long-term users had weaker hearts. ¹ PloS one, 2016\. The study is under The science, below. Watch out They can cause infertility, shrunken testicles, heart attack, stroke, liver damage and aggression. They are addictive, and stopping can bring depression. The science In detail Tell the doctor everything you take: medicines, supplements, pre-workouts, alcohol, and any steroid or fat-loss drug use now or in the past. Past steroid use is a common reason a lifter's own testosterone runs low, which makes fat harder to lose. Found **Low testosterone years after stopping.** Years after stopping steroids: lower testosterone than in those who never used, with more signs of low testosterone. Long-term use: weaker heart pumping and more artery plaque. Why Outside testosterone switches off the body's own supply, and after stopping it can stay low for years. The heart and arteries take damage while the drugs are on board. Watch The known harms: shrunken testicles, infertility, low sperm count, erection trouble, breast growth, hair loss and severe acne. Heart attack, stroke, liver and kidney problems, high blood pressure, blood clots, aggression and mood swings. They are addictive, and stopping can bring depression. How it is done Tell the doctor everything you take; At the first visit; Once #### The studies Former AAS abusers exhibited significantly lower plasma testosterone levels and higher frequencies of symptoms suggestive of hypogonadism than healthy control participants years after AAS cessation. [PMID 27532478](https://pubmed.ncbi.nlm.nih.gov/27532478/?ref=elonmuscular.com) · Former Abusers of Anabolic Androgenic Steroids Exhibit Decreased Testosterone Levels and Hypogonadal Symptoms Years after Cessation: A Case-Control Study. · PloS one, 2016 The sentence around it …Conclusions Former AAS abusers exhibited significantly lower plasma testosterone levels and higher frequencies of symptoms suggestive of hypogonadism than healthy control participants years after AAS cessation. Long-term AAS use appears to be associated with myocardial dysfunction and accelerated coronary atherosclerosis. [PMID 28533317](https://pubmed.ncbi.nlm.nih.gov/28533317/?ref=elonmuscular.com) · Cardiovascular Toxicity of Illicit Anabolic-Androgenic Steroid Use. · Circulation, 2017 The sentence around it …Conclusions Long-term AAS use appears to be associated with myocardial dysfunction and accelerated coronary atherosclerosis. Snoring and tired all day: the apnea checkSnoring and gasping means a sleep testCheck ### Snoring and tired all day: the apnea check For: Snorers Loud snoring, gasping at night and tiredness all day need a doctor and a sleep test. #### How to check 1. Ask whoever you live with whether you snore or stop breathing. 2. Snoring and tired all day? See your doctor. 3. The sleep test can usually be done at home. What it is One check When Before you start How often Once Standard practice Breathing that stops and starts, gasping, snorting or choking noises in sleep, or always feeling very tired in the day: see your doctor. Reading the number Snoring? Get tested A short questionnaire caught 92% of sleep apnea. A home monitor read the breathing correctly. ¹ Sleep & breathing = Schlaf & Atmung, 2022\. The study is under The science, below. The science In detail Loud snoring, gasping or choking at night, or waking wrecked after a full night: answer the STOP-Bang questions, then ask your doctor for a sleep test. It is treatable, and it often eases as the weight comes off. Found **Snoring, gasping, tired: a sleep test.** 38 studies against a full sleep lab: the STOP-Bang questions caught 92% of any apnea and 95% of moderate apnea. A home monitor read the breathing pattern correctly against the lab. Why Apnea breaks sleep up all night. Short, broken sleep while eating less shifts the loss from fat toward muscle and turns up hunger. How it is done Eight questions, then your doctor; Before you start; Once #### The studies The pooled sensitivity of the STOP-Bang questionnaire for AHI ≥ 5, ≥ 15, and ≥ 30 was 92%, 95%, and 96% [PMID 34406554](https://pubmed.ncbi.nlm.nih.gov/34406554/?ref=elonmuscular.com) · Diagnostic accuracy of screening questionnaires for obstructive sleep apnoea in adults in different clinical cohorts: a systematic review and meta-analysis. · Sleep & breathing = Schlaf & Atmung, 2022 The sentence around it The pooled sensitivity of the STOP-Bang questionnaire for AHI ≥ 5, ≥ 15, and ≥ 30 was 92%, 95%, and 96%, and pooled specificity was 35%, 27%, and 28%.… Pattern of disordered breathing was recognized correctly by PM. [PMID 16455365](https://pubmed.ncbi.nlm.nih.gov/16455365/?ref=elonmuscular.com) · Evaluation of type 3 portable monitoring in unattended home setting for suspected sleep apnea: factors that may affect its accuracy. · Otolaryngology--head and neck surgery, 2006 The sentence around it Pattern of disordered breathing was recognized correctly by PM. ### Free habits 1Keep lifting heavy through the cutEvery big muscle, twice a week, heavyStrong evidence ### Keep lifting heavy through the cut For: Everyone Keep lifting heavy while you cut. It is what keeps your muscle while the fat comes off. #### What to do 1. Lift 3 or 4 days a week. 2. Hit every big muscle at least twice. 3. Keep the weights you used before the cut. How much 3 or 4 sessions When Every week How long For good Standard practice Strength work for all the major muscle groups, on at least 2 days a week. What happened in the studies Nearly half the loss prevented In 34 trials, exercise prevented nearly half the muscle a diet alone would have taken. Heavy twice-weekly lifting built the most muscle. ¹ Diabetes, obesity & metabolism, 2026\. The study is under The science, below. Watch out Adding weight faster than your joints can take leads to injury. The science In detail Three or four sessions a week, every big muscle trained at least twice: squat, hinge, push, pull and carry. Keep the loads you used before the cut. The lifting is what tells the body to keep the muscle while the fat comes off, so the abs show on a body that still looks strong. Found **Nearly half the muscle loss prevented.** 34 trials of eating less: adding exercise prevented nearly half the lean mass that dieting alone would have lost. 119 studies on size: heavy, multi-set, twice-weekly training ranked first for building muscle. Why Eating less tells the body to spend tissue. Lifting tells it which tissue to keep. Heavy load switches on protein building for a day or two, even in a deficit. Watch Injury when you chase weight faster than tendons and joints adapt. #### The studies On average, EX prevented nearly half of FFM loss (45.7%). [PMID 42144246](https://pubmed.ncbi.nlm.nih.gov/42144246/?ref=elonmuscular.com) · Effects of Calorie Restriction With and Without Strength, Endurance or Mixed Training on Fat-Free and Skeletal Muscle Mass in Overweight or Obese Individuals-A Systematic Review With Pairwise Meta-Analysis and Network Meta-Analysis of Randomized Controlled Studies. · Diabetes, obesity & metabolism, 2026 The sentence around it On average, EX prevented nearly half of FFM loss (45.7%). higher-load, multiset, twice-weekly training (0.66 (0.47 to 0.85) vs CTRL) was the highest-ranked RTx for hypertrophy [PMID 37414459](https://pubmed.ncbi.nlm.nih.gov/37414459/?ref=elonmuscular.com) · Resistance training prescription for muscle strength and hypertrophy in healthy adults: a systematic review and Bayesian network meta-analysis. · British journal of sports medicine, 2023 The sentence around it …While the calculated effects of many prescriptions were similar, higher-load, multiset, thrice-weekly training (standardised mean difference (95% credible interval); 1.60 (1.38 to 1.82) vs CTRL) was the highest-ranked RTx for strength, and higher-load, multiset, twice-weekly training (0.66 (0.47 to 0.85) vs CTRL) was the highest-ranked RTx for hypertrophy.… [The deep dive on this](https://elonmuscular.com/resistance-training/) 2Keep the sets up: about ten a muscleTen or more hard sets per muscle, kept upEarly evidence ### Keep the sets up: about ten a muscle For: Everyone lifting Keep doing about 10 hard sets per muscle each week while you cut. #### What to do 1. Count hard sets per muscle, per week. 2. Keep it at about 10 or more. 3. Recovering well? Add 1 or 2 over the weeks. How much About 10 sets a muscle When Each week How long The whole cut What happened in the studies Keep the sets, keep the muscle Programs that kept raising the sets during a diet lost little or no muscle. ¹ European journal of applied physiology, 2022\. The study is under The science, below. Watch out Sore joints and weaker lifts mean you are doing too much. The science In detail Count the hard sets each muscle gets in a week and keep it at about ten or more through the cut. Do not trim the volume to save energy. Recovering well? Add a set or two over the weeks. Found **10 hard sets or more.** 15 studies of lifting on fewer calories: programs that raised the volume over time lost little or no lean mass, unlike programs that cut it. A second set of pooled studies: more weekly sets, more muscle. Why Each hard set is a dose of the signal to keep muscle. Cutting sets during a diet takes away the reason to keep it. Watch Aching joints and lifts going backwards mean the volume has outrun recovery. #### The studies Additionally, studies increasing RT volume during CR over time appeared to demonstrate no-to-low lean mass loss when compared to studies reducing RT volume. [PMID 35146569](https://pubmed.ncbi.nlm.nih.gov/35146569/?ref=elonmuscular.com) · Lean mass sparing in resistance-trained athletes during caloric restriction: the role of resistance training volume. · European journal of applied physiology, 2022 The sentence around it Additionally, studies increasing RT volume during CR over time appeared to demonstrate no-to-low lean mass loss when compared to studies reducing RT volume. The findings indicate a graded dose-response relationship whereby increases in RT volume produce greater gains in muscle hypertrophy. [PMID 27433992](https://pubmed.ncbi.nlm.nih.gov/27433992/?ref=elonmuscular.com) · Dose-response relationship between weekly resistance training volume and increases in muscle mass: A systematic review and meta-analysis. · Journal of sports sciences, 2017 The sentence around it The findings indicate a graded dose-response relationship whereby increases in RT volume produce greater gains in muscle hypertrophy. [The deep dive on this](https://elonmuscular.com/lab-mev-mav-mrv/) 3Train abs for strength and shapeLoaded ab work twice a week; the fat comes off everywhereModerate evidence ### Train abs for strength and shape For: Everyone Train abs for strength and shape. The fat comes off everywhere, belly included, as you cut. #### What to do 1. Pick 2 or 3 loaded ab moves. 2. Twice a week, 6 to 12 hard reps a set. 3. Add weight when the reps get easy. How much 2 or 3 moves When Twice a week How long For good What happened in the studies Strong abs, fat off everywhere Ab training built ab strength, 47 curl-ups against 32\. Training one leg took fat off the arms and trunk. ¹ Journal of strength and conditioning research, 2011\. The study is under The science, below. Watch out Back pain on sit-ups? Switch to cable crunches or the ab wheel from your knees. The science In detail Train your abs like any other muscle: two or three loaded moves, twice a week, about 6 to 12 hard reps a set. Cable or weighted crunches, hanging leg raises, the ab wheel, and a heavy carry. Stronger, thicker abs show sooner. The fat over them comes off everywhere at once, as the deficit runs. Found **Stronger abs; fat off everywhere.** Six weeks of ab training built muscular endurance: 47 curl-ups against 32 without it. Twelve weeks of training one leg took fat off the arms and trunk, 10.2% and 6.9%: the body pulls fat from everywhere. Why Training grows the muscle; the deficit strips the fat. A thicker six-pack pushes against the layer of fat, so stronger abs can show through a little more of it. The fat itself comes off the whole body at once, the belly included. Watch Low back pain on sit-ups or leg raises: swap to the ab wheel from the knees or cable crunches, and keep the lower back still. #### The studies The AG performed significantly greater amount of curl-up repetitions (47 ± 13) compared to the CG (32 ± 9) on the posttest. [PMID 21804427](https://pubmed.ncbi.nlm.nih.gov/21804427/?ref=elonmuscular.com) · The effect of abdominal exercise on abdominal fat. · Journal of strength and conditioning research, 2011 The sentence around it The AG performed significantly greater amount of curl-up repetitions (47 ± 13) compared to the CG (32 ± 9) on the posttest. A significant (p < 0.05) decrease in fat mass was observed in the upper extremities and trunk (10.2 and 6.9%, respectively, p < 0.05). [PMID 23222084](https://pubmed.ncbi.nlm.nih.gov/23222084/?ref=elonmuscular.com) · Regional fat changes induced by localized muscle endurance resistance training. · Journal of strength and conditioning research, 2013 The sentence around it A significant (p < 0.05) decrease in fat mass was observed in the upper extremities and trunk (10.2 and 6.9%, respectively, p < 0.05). 4The pace: 0.5 to 1% a week0.5 to 1% a week, slower as you get leanStrong evidence ### The pace: 0.5 to 1% a week For: Everyone cutting Lose about 0.5 to 1% of your body weight a week. Slower as you get leaner keeps the muscle. #### What to do 1. Find the intake that holds your weight steady for 2 weeks. 2. Eat a little less, never more than 500 calories under. 3. Once the abs start to show, slow to about 0.7% a week or less. How much Up to 500 calories less When Every day How long The whole cut Standard practice Lose weight steadily: aim to lose about 1 to 2 lb a week. What happened in the studies 0.5to 1% a week The reviews set the pace at 0.5 to 1% a week. In a trial, 0.7% a week with lifting added 2.1% lean mass. ¹ Journal of the International Society of Sports Nutrition, 2014\. The study is under The science, below. Watch out Always hungry, weaker or sleeping badly? The deficit is too big. Eat a bit more. The science In detail Eat a little under what holds your weight steady, enough to lose 0.5 to 1% of body weight a week. The leaner you get, the slower you go: about 0.7% or less once the abs start to show. Never more than about 500 calories a day under maintenance if you want to keep the muscle. Found Two reviews of fat-loss phases: 0.5 to 1% of body weight a week keeps the most muscle. A trial of two paces: losing 0.7% a week while lifting 4 times a week added 2.1% lean mass. A review of the trials: keep the deficit within 500 calories a day. Why A big deficit takes muscle along with the fat, and the leaner you are, the harder the body fights to hold its last fat. A steady, smaller deficit leaves the energy to train hard. Watch Hungry all the time, lifts falling or sleep breaking up: the deficit is too big. Eat a little more. The doses the studies used**0.7% a week** *the pace that added lean mass and strength in the trial* 0.5% a week0.7% a week1% a week a weekly body-weight (BW) loss of 0.7% slow reduction (SR) [PMID 21558571](https://pubmed.ncbi.nlm.nih.gov/21558571/?ref=elonmuscular.com) #### The studies Caloric intake should be set at a level that results in bodyweight losses of approximately 0.5 to 1%/wk to maximize muscle retention. [PMID 24864135](https://pubmed.ncbi.nlm.nih.gov/24864135/?ref=elonmuscular.com) · Evidence-based recommendations for natural bodybuilding contest preparation: nutrition and supplementation. · Journal of the International Society of Sports Nutrition, 2014 The sentence around it Caloric intake should be set at a level that results in bodyweight losses of approximately 0.5 to 1%/wk to maximize muscle retention. LBM increased in SR by 2.1% ± 0.4% (p < .001) [PMID 21558571](https://pubmed.ncbi.nlm.nih.gov/21558571/?ref=elonmuscular.com) · Effect of two different weight-loss rates on body composition and strength and power-related performance in elite athletes. · International journal of sport nutrition and exercise metabolism, 2011 The sentence around it LBM increased in SR by 2.1% ± 0.4% (p < .001) [The deep dive on this](https://elonmuscular.com/calorie-restriction/) 5Protein: 1 g per pound (2.2 g per kilo) or more1 to 1.4 g of protein per pound (2.2 to 3.0 g per kilo), every dayStrong evidence ### Protein: 1 g per pound (2.2 g per kilo) or more For: Everyone Eat a lot of protein while you cut: 1 to 1.4 grams per pound of body weight (2.2 to 3 grams per kilo) a day. #### What to do 1. Weigh yourself. Use your weight in pounds (in kilos, multiply by 2.2). 2. That is your daily protein floor in grams. 3. Getting lean? Move toward 1.4 g per pound (3 g per kilo). How much 1 to 1.4 g per pound (2.2 to 3 g per kilo) When Every day How long The whole cut What happened in the studies 1to 1.4 g per pound (2.2 to 3.0 g per kilo) On 40% less food, 1.1 grams per pound (2.4 grams per kilo) added 2.5 lb (1.2 kg) of lean mass while the fat came off. ¹ Nutrients, 2021\. The study is under The science, below. Watch out Healthy kidneys handle it. With kidney disease, ask a doctor first. The science In detail Eat 1 to 1.4 g of protein per pound of body weight (2.2 to 3.0 g per kilo) a day through the cut, nearer the top as you get leaner. For a 176 lb (80 kg) man, that is about 176 to 240 g. Meat, fish, eggs, dairy, soy, beans and lentils all count. Found **1 to 1.4 g per pound (2.2 to 3.0 g per kilo) a day.** Four weeks of lifting and intervals on 40% less food: 1.1 g of protein per pound (2.4 g per kilo) added 2.5 lb (1.2 kg) of lean mass while fat came off. It beat 1.2 g on both. The fat-loss review: 1 to 1.4 g per pound (2.2 to 3.0 g per kilo) a day. Why Eating less makes the body break down more protein. More protein coming in covers the loss, and it fills you up more than carbs or fat for the same calories, which makes a cut easier to hold. The doses the studies used**1 g/lb (2.2 g/kg)** *the start of the fat-loss range* 0.7 g/lb (1.6 g/kg)1 g/lb (2.2 g/kg)1.1 g/lb (2.4 g/kg)1.4 g/lb (3.0 g/kg) Protein intake (2.2-3.0 g/kgBW/day) [PMID 34579132](https://pubmed.ncbi.nlm.nih.gov/34579132/?ref=elonmuscular.com) #### The studies Protein intake (2.2-3.0 g/kgBW/day) should be distributed throughout the day (3-6 meals), ensuring in each meal an adequate amount of protein (0.40-0.55 g/kgBW/meal) and including a meal within 2-3 h before and after training. [PMID 34579132](https://pubmed.ncbi.nlm.nih.gov/34579132/?ref=elonmuscular.com) · Achieving an Optimal Fat Loss Phase in Resistance-Trained Athletes: A Narrative Review. · Nutrients, 2021 The sentence around it Protein intake (2.2-3.0 g/kgBW/day) should be distributed throughout the day (3-6 meals), ensuring in each meal an adequate amount of protein (0.40-0.55 g/kgBW/meal) and including a meal within 2-3 h before and after training. LBM increased (P < 0.05) in the PRO group (1.2 ± 1.0 kg) and to a greater extent (P < 0.05) compared with the CON group (0.1 ± 1.0 kg). [PMID 26817506](https://pubmed.ncbi.nlm.nih.gov/26817506/?ref=elonmuscular.com) · Higher compared with lower dietary protein during an energy deficit combined with intense exercise promotes greater lean mass gain and fat mass loss: a randomized trial. · The American journal of clinical nutrition, 2016 The sentence around it …Results As a result of the intervention, LBM increased (P < 0.05) in the PRO group (1.2 ± 1.0 kg) and to a greater extent (P < 0.05) compared with the CON group (0.1 ± 1.0 kg). 6Protein at every meal, one around training0.18 to 0.25 g per pound (0.4 to 0.55 g per kilo) a meal, over 3 to 6 mealsModerate evidence ### Protein at every meal, one around training For: Everyone Spread your protein over several meals instead of 1 or 2 big ones. #### What to do 1. Three to six meals, each with a real serving of protein. 2. About 32 to 44 grams each, for a 176 lb (80 kg) man. 3. One before training, one after. How much 3 to 6 meals When Across the day How long For good What happened in the studies A meal before and after training A review's target: 0.18 to 0.25 grams per pound (0.40 to 0.55 grams per kilo) at each meal, with one before and one after training. ¹ Nutrients, 2021\. The study is under The science, below. The science In detail Split the protein over 3 to 6 meals, about 0.18 to 0.25 g per pound (0.4 to 0.55 g per kilo) each. For a 176 lb (80 kg) man, about 32 to 44 g a meal. Put one meal in the 2 to 3 hours before training and one in the 2 to 3 hours after. Found **0.18 to 0.25 g per pound (0.4 to 0.55 g per kilo) a meal.** The fat-loss review: 3 to 6 meals, 0.18 to 0.25 g per pound (0.40 to 0.55 g per kilo) a meal, with a meal within 2 to 3 hours before and after training. The per-meal review: 0.18 g per pound (0.4 g per kilo) over at least four meals. Why Each protein meal switches muscle building on for a few hours. More meals keep it on for more of the day, which matters most when food is short. #### The studies ensuring in each meal an adequate amount of protein (0.40-0.55 g/kgBW/meal) and including a meal within 2-3 h before and after training. [PMID 34579132](https://pubmed.ncbi.nlm.nih.gov/34579132/?ref=elonmuscular.com) · Achieving an Optimal Fat Loss Phase in Resistance-Trained Athletes: A Narrative Review. · Nutrients, 2021 The sentence around it …Protein intake (2.2-3.0 g/kgBW/day) should be distributed throughout the day (3-6 meals), ensuring in each meal an adequate amount of protein (0.40-0.55 g/kgBW/meal) and including a meal within 2-3 h before and after training. Based on the current evidence, we conclude that to maximize anabolism one should consume protein at a target intake of 0.4 g/kg/meal across a minimum of four meals in order to reach a minimum of 1.6 g/kg/day. [PMID 29497353](https://pubmed.ncbi.nlm.nih.gov/29497353/?ref=elonmuscular.com) · How much protein can the body use in a single meal for muscle-building? Implications for daily protein distribution. · Journal of the International Society of Sports Nutrition, 2018 The sentence around it Based on the current evidence, we conclude that to maximize anabolism one should consume protein at a target intake of 0.4 g/kg/meal across a minimum of four meals in order to reach a minimum of 1.6 g/kg/day. 7Carbs for training, some fat every dayFat 10 to 25% of calories; carbs matched to trainingModerate evidence ### Carbs for training, some fat every day For: Everyone After protein, keep some fat and use carbs to fuel your training. #### What to do 1. Set protein first. 2. Fat at about 10 to 25% of calories. 3. The rest from carbs, most on training days. How much Carbs to match training When Every day How long The whole cut What happened in the studies Fat 10 to 25%, carbs to train The review keeps fat at 10 to 25% of calories so carbs can protect training while dieting. ¹ Journal of human kinetics, 2020\. The study is under The science, below. The science In detail Once protein is set, fill the rest. Fat at about 10 to 25% of calories, never zero. Carbs fill the remainder, matched to training: more on lifting days, and around the session. Cut carbs as far as a low-carb diet only if it suits you, and keep the lifting strong. Found **Fat 10 to 25%; carbs for training.** The review of lean-physique nutrition: low-end fat of 10 to 25% of calories leaves room for carbs to protect training on a diet. A scoping review of expert guidance: carbs periodized on training demands, 1.4 to 5.4 g per pound (3 to 12 g per kilo) depending on the load. Why Carbs fuel hard sets, so cutting them to nothing hurts training and the muscle it protects. Some fat keeps hormones and meals livable. #### The studies low-end fat intake during contest preparation of 10-25% of calories allows for what calories remain in the "energy budget" to come from carbohydrate to mitigate the negative impact of energy restriction and weight loss on training performance. [PMID 32148575](https://pubmed.ncbi.nlm.nih.gov/32148575/?ref=elonmuscular.com) · Nutritional Recommendations for Physique Athletes. · Journal of human kinetics, 2020 The sentence around it …Furthermore, as a benefit from having adequate carbohydrate to fuel performance and activity, low-end fat intake during contest preparation of 10-25% of calories allows for what calories remain in the "energy budget" to come from carbohydrate to mitigate the negative impact of energy restriction and weight loss on training performance. periodising carbohydrate intake (3-12 g/kg/day) on the basis of training demands. [PMID 40841871](https://pubmed.ncbi.nlm.nih.gov/40841871/?ref=elonmuscular.com) · Dietary Recommendations for Body Mass and Composition Manipulation in Male and Female Athletes: a Scoping Review of Consensus Statements, Position Stands and Practice Guidelines from International Expert Groups. · Sports medicine (Auckland, N.Z.), 2025 The sentence around it …Common strategies for altering body mass and composition included creating an energy surplus (500-1000 kcal/day) or deficit (250-1000 kcal/day), maintaining energy availability above 30 kcal/kg fat-free mass/day, and periodising carbohydrate intake (3-12 g/kg/day) on the basis of training demands. 8Any eating style that holds the deficitLow-carb, low-fat or neither: the one you keepStrong evidence ### Any eating style that holds the deficit For: Everyone Low-carb, low-fat or neither: any diet works if you keep to it and hit the protein. #### What to do 1. Pick the style you can keep for months. 2. Hit the protein first. 3. Swap drinks with calories, beer included, for water or diet drinks. How much Your usual meals, adjusted When Every day How long For good Standard practice Cut down on high-fat or sugary foods, eat plenty of fruit and vegetables, and cut down on alcohol, which is high in calories. What happened in the studies The one you keep Low-fat, low-carb and everything between improved body composition about equally. Sticking to it decides. ¹ Journal of the International Society of Sports Nutrition, 2017\. The study is under The science, below. The science In detail Pick the way of eating you can keep for months: more carbs or fewer, three meals or five, any mix of foods. The protein and the pace are what must hold. Swap drinks with calories for water or diet drinks, and build meals around protein and vegetables. Beer counts: see [Drinking less](https://elonmuscular.com/protocol-drinking-less/). Found **Any style, same result.** The position stand on diets and body composition: diets from low-fat to low-carb and keto, and all points between, can improve body composition about equally. A diet's long-term success depends on sticking to it. Why Fat loss runs on the deficit, not on a food list. The best cut is the one you are still following in month three. #### The study A wide range of dietary approaches (low-fat to low-carbohydrate/ketogenic, and all points between) can be similarly effective for improving body composition. [PMID 28630601](https://pubmed.ncbi.nlm.nih.gov/28630601/?ref=elonmuscular.com) · International society of sports nutrition position stand: diets and body composition. · Journal of the International Society of Sports Nutrition, 2017 The sentence around it A wide range of dietary approaches (low-fat to low-carbohydrate/ketogenic, and all points between) can be similarly effective for improving body composition. The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis. The sentence around it The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis. 9Walk more, and keep it upAbout 8,500 steps a day, held through the cutModerate evidence ### Walk more, and keep it up For: Everyone Walk more. Your body quietly moves less when you diet, and steps put that back. #### What to do 1. Count your steps for a week. 2. Build toward about 8,500 a day. 3. Walk after meals, take the stairs, pace on calls. How much About 8,500 steps When Every day How long For good Standard practice Sit less, and break up long periods of not moving with some activity. What happened in the studies Everyday movement falls most As weight comes off, everyday movement falls more than any other part of the burn. It explained 10-fold differences in fat gain. ¹ Health science reports, 2026\. The study is under The science, below. The science In detail Count your steps for a week, then build toward about 8,500 a day, and hold it for the whole cut. Walk after meals, take the stairs, pace on calls. Found **About 8,500 steps a day.** The review of weight-loss plateaus: of all the energy the body spends, everyday movement falls the most as weight comes off. An overfeeding study: everyday movement explained 10-fold differences in fat gained. The steps review of the trials target: about 8,500 a day. Why Eating less quietly makes you move less: less fidgeting, standing and pacing. That drop can swallow the deficit and stall the cut. Counting steps keeps the everyday burn from sliding. #### The studies Although all components of TEE decrease during WL, the most significant reduction is often observed in non-exercise activity thermogenesis (NEAT). [PMID 42466371](https://pubmed.ncbi.nlm.nih.gov/42466371/?ref=elonmuscular.com) · Weight Loss Plateau: Reasons, Challenges, and Solutions: A Narrative Review. · Health science reports, 2026 The sentence around it Although all components of TEE decrease during WL, the most significant reduction is often observed in non-exercise activity thermogenesis (NEAT). Changes in NEAT accounted for the 10-fold differences in fat storage that occurred and directly predicted resistance to fat gain with overfeeding (correlation coefficient = 0.77, probability < 0.001). [PMID 9880251](https://pubmed.ncbi.nlm.nih.gov/9880251/?ref=elonmuscular.com) · Role of nonexercise activity thermogenesis in resistance to fat gain in humans. · Science (New York, N.Y.), 1999 The sentence around it Changes in NEAT accounted for the 10-fold differences in fat storage that occurred and directly predicted resistance to fat gain with overfeeding (correlation coefficient = 0.77, probability < 0.001). 10Cardio on top of the liftingCardio on top of the lifting, never insteadStrong evidence ### Cardio on top of the lifting For: Everyone Add cardio on top of your lifting. Exercise on a diet keeps muscle, and cardio adds to the burn. #### What to do 1. Keep the cardio you enjoy. 2. Same session? Lift first. 3. Count it in the deficit. How much 150 minutes a week When After lifting, or apart How long For good Standard practice At least 150 minutes of moderate activity a week, or 75 minutes of vigorous activity, on top of the strength work. What happened in the studies 2lb(0.87 kg) more muscle kept In 34 trials, adding exercise to a diet kept 2 lb (0.87 kg) more lean mass than the diet alone. ¹ Diabetes, obesity & metabolism, 2026\. The study is under The science, below. Watch out Cardio burns calories. Count it, so the cut stays at the right pace. The science In detail Keep the cardio you enjoy, on top of the lifting, never instead of it. Lift first if both land in one session. It adds to the burn without cutting food further. Found **2 lb (0.87 kg) more lean mass kept.** 34 trials of eating less: adding exercise kept 2 lb (0.87 kg) more lean mass than dieting alone. The verdict: exercise is very effective at cutting the lean mass lost on a diet. Why Muscle is kept by the lifting. Cardio adds to the deficit, so you can eat a little more and still lose, and a fitter heart recovers faster between sets. Watch Cardio burns calories: count it, so the deficit stays within the pace. #### The study Results A random-effects model showed a significant effect of EX on FFM, with a pooled mean difference favouring CR combined with EX over CR alone (mean difference (MD) = +0.87 kg; 95% confidence interval (CI): +0.59, +1.16 kg; p ≤ 0.001). [PMID 42144246](https://pubmed.ncbi.nlm.nih.gov/42144246/?ref=elonmuscular.com) · Effects of Calorie Restriction With and Without Strength, Endurance or Mixed Training on Fat-Free and Skeletal Muscle Mass in Overweight or Obese Individuals-A Systematic Review With Pairwise Meta-Analysis and Network Meta-Analysis of Randomized Controlled Studies. · Diabetes, obesity & metabolism, 2026 The sentence around it Results A random-effects model showed a significant effect of EX on FFM, with a pooled mean difference favouring CR combined with EX over CR alone (mean difference (MD) = +0.87 kg; 95% confidence interval (CI): +0.59, +1.16 kg; p ≤ 0.001). Conclusions Exercise training is very effective in reducing FFM loss during CR. The sentence around it Conclusions Exercise training is very effective in reducing FFM loss during CR. 11Sleep seven to nine hoursSeven to nine hours, at the same timesModerate evidence ### Sleep seven to nine hours For: Everyone Sleep is part of the diet. Short nights turn fat loss into muscle loss and make you hungrier. #### What to do 1. Sleep 7 to 9 hours. 2. Same bed and wake times, weekends too. 3. Short sleeper? Add 30 to 60 minutes in bed. How much 7 to 9 hours When Every night How long For good What happened in the studies 55%less fat lost On the same diet, short sleep cut the fat lost by 55%. Sleeping longer cut the sugar eaten. ¹ Annals of internal medicine, 2010\. The study is under The science, below. Watch out If you sleep 9 hours or more and still wake tired, see a doctor. The science In detail Seven to nine hours asleep, at the same times, seven days a week. On a cut, sleep decides how much of the loss is fat. Short sleeper? Add time in bed: 30 to 60 minutes more is a start. See [Night cravings](https://elonmuscular.com/protocol-night-cravings/) if the evenings are where the diet breaks. Found **55% less fat lost on short sleep.** Two weeks on the same diet: 5.5 hours in bed instead of 8.5 cut the fat lost by 55%. Four weeks of sleeping longer: less sugar eaten, 9.6 g a day less. Why Short sleep raises hunger, cuts the fat burned, and raises the hormones that break muscle down. The same diet then takes more muscle and less fat. Watch Nine hours or more a night that does not refresh is a reason to see a doctor, not a target. #### The studies Sleep curtailment decreased the proportion of weight lost as fat by 55% (1.4 vs. 0.6 kg with 8.5 vs. 5.5 hours of sleep opportunity, respectively; P = 0.043) [PMID 20921542](https://pubmed.ncbi.nlm.nih.gov/20921542/?ref=elonmuscular.com) · Insufficient sleep undermines dietary efforts to reduce adiposity. · Annals of internal medicine, 2010 The sentence around it …Results Sleep curtailment decreased the proportion of weight lost as fat by 55% (1.4 vs. 0.6 kg with 8.5 vs. 5.5 hours of sleep opportunity, respectively; P = 0.043) and increased the loss of fat-free body mass by 60% (1.5 vs.… Sleep extension led to reduced intake of free sugars (-9.6 g; 95% CI: -16.0, -3.1 g) compared with control (0.7 g; 95% CI: -5.7, 7.2 g) (P = 0.042). [PMID 29381788](https://pubmed.ncbi.nlm.nih.gov/29381788/?ref=elonmuscular.com) · Sleep extension is a feasible lifestyle intervention in free-living adults who are habitually short sleepers: a potential strategy for decreasing intake of free sugars? A randomized controlled pilot study. · The American journal of clinical nutrition, 2018 The sentence around it Sleep extension led to reduced intake of free sugars (-9.6 g; 95% CI: -16.0, -3.1 g) compared with control (0.7 g; 95% CI: -5.7, 7.2 g) (P = 0.042). [The deep dive on this](https://elonmuscular.com/sleep/) ### Over the counter 12Creatine3 to 5 g of creatine monohydrate, every dayStrong evidence ### Creatine, 3 to 5 g a day For: Everyone lifting The best-proven muscle supplement. It lets your muscles do more work in each set, even on less food. #### What to do 1. Take 3 to 5 grams of creatine monohydrate a day. 2. Optional: 20 grams a day for the first 6 days fills the muscle faster. 3. Keep taking it. The time of day does not matter. How much 3 to 5 grams When Any time, daily How long For good What happened in the studies More strength, more muscle In 63 studies with 1,489 people, lifting with creatine built more strength and muscle than lifting alone. ¹ Journal of the International Society of Sports Nutrition, 2026\. The study is under The science, below. Watch out A little water weight at first. That is the muscle, not fat. It has been studied as safe for years. The science In detail 3 to 5 g of creatine monohydrate a day, every day, with any meal. To fill the muscle faster, take 20 g a day for 6 days first, split through the day. Found **63 studies, 1,489 people.** 63 studies, 1,489 people: lifting with creatine built more upper- and lower-body strength and more lean mass than lifting alone, and body fat percentage fell slightly. A second review: with lifting, creatine adds strength during weight loss. Why A muscle runs its hardest few seconds on phosphocreatine. Creatine tops that store up, so hard sets last a little longer, which matters most when food is short. Watch Some water weight in the first weeks: that is the muscle filling up, not fat. Read the scale with the tape. Safety: studied up to 30 g a day for 5 years and well tolerated. The doses the studies used**3 g a day** *the steady dose: fills the muscle over about 4 weeks* 3 g a day20 g a day The ingestion of 3 g creatine/day is in the long term likely to be as effective at raising tissue levels as this higher dose. [PMID 8828669](https://pubmed.ncbi.nlm.nih.gov/8828669/?ref=elonmuscular.com) #### The studies The modest increase in total body weight was primarily attributable to gains in lean body mass, contributing to a slight reduction in body fat percentage. [PMID 42765482](https://pubmed.ncbi.nlm.nih.gov/42765482/?ref=elonmuscular.com) · Resistance training combined with creatine supplementation: a three-level meta-analysis of multidimensional outcomes from strength enhancement to body composition remodeling. · Journal of the International Society of Sports Nutrition, 2026 The sentence around it The modest increase in total body weight was primarily attributable to gains in lean body mass, contributing to a slight reduction in body fat percentage. When combined with resistance training, whey protein can help preserve lean body mass during weight loss, with additional strength benefits from creatine monohydrate and β-Hydroxy β-Methylbutyrate supplementation. [PMID 41368199](https://pubmed.ncbi.nlm.nih.gov/41368199/?ref=elonmuscular.com) · Dietary supplement considerations during glucagon-like Peptide-1 receptor agonist treatment: A narrative review. · Obesity pillars, 2025 The sentence around it When combined with resistance training, whey protein can help preserve lean body mass during weight loss, with additional strength benefits from creatine monohydrate and β-Hydroxy β-Methylbutyrate supplementation. [The deep dive on this](https://elonmuscular.com/creatine/) 13Whey Protein ConcentrateA whey shake when food falls shortModerate evidence ### Whey, to hit the protein number For: Short of protein A whey shake helps you hit your protein target without many calories. #### What to do 1. Hit your protein target from food first. 2. Short? Add a shake of 20 to 40 grams of whey. 3. Mix it in water to keep the calories down. How much 20 to 40 g When When you are short How long The whole cut What happened in the studies Muscle kept while losing A review found whey with lifting helps keep muscle during weight loss. ¹ Obesity pillars, 2025\. The study is under The science, below. Watch out Some people get stomach upset. Not with a milk allergy. The science In detail Short of 1 g per pound (2.2 g per kilo)? A shake of whey closes the gap: 20 to 40 g of protein, in water to keep the calories down. It is food in a tub. Found **20 to 40 g a shake.** A review of supplements during weight loss: with lifting, whey helps keep lean mass. The protein position stand: 20 to 40 g of good protein a serving. Why Whey is milk protein that digests fast and is rich in leucine, so it switches muscle building on quickly, for few calories. Watch Stomach upset for some. A milk allergy rules it out. #### The studies When combined with resistance training, whey protein can help preserve lean body mass during weight loss [PMID 41368199](https://pubmed.ncbi.nlm.nih.gov/41368199/?ref=elonmuscular.com) · Dietary supplement considerations during glucagon-like Peptide-1 receptor agonist treatment: A narrative review. · Obesity pillars, 2025 The sentence around it When combined with resistance training, whey protein can help preserve lean body mass during weight loss, with additional strength benefits from creatine monohydrate and β-Hydroxy β-Methylbutyrate supplementation.… General recommendations are 0.25 g of a high-quality protein per kg of body weight, or an absolute dose of 20-40 g. [PMID 28642676](https://pubmed.ncbi.nlm.nih.gov/28642676/?ref=elonmuscular.com) · International Society of Sports Nutrition Position Stand: protein and exercise. · Journal of the International Society of Sports Nutrition, 2017 The sentence around it General recommendations are 0.25 g of a high-quality protein per kg of body weight, or an absolute dose of 20-40 g. [The deep dive on this](https://elonmuscular.com/whey-protein-concentrate/) 14CaffeineOptional: 3 to 6 mg per kilo (1.4 to 2.7 mg per lb) before training, 400 mg a day at mostModerate evidence ### Caffeine before a session, if you like it For: Harder sessions Optional: caffeine before training lets you push a little harder when you are eating less. #### What to do 1. 3 mg per kilo (1.4 mg per lb) is about 240 mg for a 176 lb (80 kg) man. 2. About an hour before training. 3. Never over 400 mg a day, and never close to bed. How much From 240 mg When An hour before training How long Same day What happened in the studies A harder session Caffeine at 3 to 6 mg per kilo (1.4 to 2.7 mg per lb) improves performance. Stay under 400 mg a day in all. ¹ Journal of the International Society of Sports Nutrition, 2021\. The study is under The science, below. Watch out It can ruin your sleep. Stay under 400 mg a day, coffee included. The science In detail Optional: 3 to 6 mg per kilo (1.4 to 2.7 mg per lb) about an hour before training, and never over 400 mg in a day from all sources. For a 176 lb (80 kg) man, 240 mg is the low end. Keep it well away from bedtime. Found **3 to 6 mg per kilo (1.4 to 2.7 mg per lb).** The caffeine position stand: 3 to 6 mg per kilo (1.4 to 2.7 mg per lb) consistently improves exercise performance, and the lowest dose that works may be 2 mg per kilo (0.9 mg per lb). The safety ceiling from a separate review: 400 mg a day. Why Caffeine blocks the tiredness signal, adenosine, so a hard set feels lighter on less food. It helps the session, and the session keeps the muscle. Watch It can wreck sleep, and short sleep on a cut takes muscle. Jitters, a racing heart and anxiety at higher doses. Count coffee, energy drinks and pre-workouts in the total. The doses the studies used**3 to 6 mg/kg (1.4 to 2.7 mg/lb)** *the position stand's dose* 2 mg/kg (0.9 mg/lb)3 to 6 mg/kg (1.4 to 2.7 mg/lb) Caffeine has consistently been shown to improve exercise performance when consumed in doses of 3-6 mg/kg body mass. [PMID 33388079](https://pubmed.ncbi.nlm.nih.gov/33388079/?ref=elonmuscular.com) #### The study Caffeine has consistently been shown to improve exercise performance when consumed in doses of 3-6 mg/kg body mass. [PMID 33388079](https://pubmed.ncbi.nlm.nih.gov/33388079/?ref=elonmuscular.com) · International society of sports nutrition position stand: caffeine and exercise performance. · Journal of the International Society of Sports Nutrition, 2021 The sentence around it Caffeine has consistently been shown to improve exercise performance when consumed in doses of 3-6 mg/kg body mass. may be as low as 2 mg/kg body mass. The sentence around it may be as low as 2 mg/kg body mass. [The deep dive on this](https://elonmuscular.com/caffeine/) 15Psyllium Seed HusksPsyllium, about 11 g a day, just before mealsModerate evidence ### Psyllium before meals For: Holding the deficit A fiber powder in water before meals. It fills you up, and it took weight and waist off in trials. #### What to do 1. Stir about 11 grams into a full glass of water. 2. Drink it just before meals. 3. Keep it apart from your pills. How much About 11 grams When Before meals How long The whole cut What happened in the studies 0.9in (2.2 cm) off the waist In 6 trials with 354 people, psyllium before meals took 4.5 lb (2.1 kg) off body weight and 0.9 in (2.2 cm) off the waist. ¹ Journal of the American Association of Nurse Practitioners, 2023\. The study is under The science, below. Watch out Gas and bloating at first: build up slowly. Always with a full glass of water: taken dry it can swell and choke you or block the gut. Not with trouble swallowing or a narrowed gut. Keep it apart from your pills. On diabetes drugs, blood sugar can drop further. Rarely an allergy. Some products carry lead: choose a tested one. The science In detail About 11 g of psyllium husk a day, stirred into a full glass of water just before meals. Build up over a week or two, and keep it well apart from your pills. Found Six trials, 354 people: psyllium just before meals took 4.5 lb (2.1 kg) off body weight and 0.9 in (2.2 cm) off the waist. The average dose was 10.8 g a day, for 4.8 months. Why In the gut, psyllium forms a thick gel that slows how fast a meal is broken down and absorbed. That makes the deficit easier to hold. Watch Bloating and gas at first: build the dose up slowly. Always with a full glass of water: taken dry it can swell and block the throat or the gut, so not with trouble swallowing or a narrowed gut. It slows the absorption of pills taken at the same time: keep them apart. With diabetes drugs, blood sugar can drop further. Rarely an allergy. Some products carry lead: choose a tested one. The doses the studies used**10.8 g a day** *the average dose across six trials, just before meals* 10.8 g a day dosed just before meals (mean dose 10.8 g/day, mean duration 4.8 months) [PMID 37163454](https://pubmed.ncbi.nlm.nih.gov/37163454/?ref=elonmuscular.com) #### The study In the small intestine, psyllium gel increases chyme viscosity, slowing the degradation and absorption of nutrients. [PMID 37163454](https://pubmed.ncbi.nlm.nih.gov/37163454/?ref=elonmuscular.com) · Psyllium is a natural nonfermented gel-forming fiber that is effective for weight loss: A comprehensive review and meta-analysis. · Journal of the American Association of Nurse Practitioners, 2023 The sentence around it In the small intestine, psyllium gel increases chyme viscosity, slowing the degradation and absorption of nutrients. [The deep dive on this](https://elonmuscular.com/psyllium-seed-husks/) 16OrlistatA capsule with each fatty meal; a multivitamin at bedtimeModerate evidence ### Orlistat: the fat-blocking capsule For: From a pharmacy A capsule with each fatty meal that stops some of the fat being absorbed. The lower dose is sold in pharmacies. #### What to do 1. 60 mg from a pharmacy in the UK, over the counter in the US; 120 mg on prescription. 2. One capsule with each main meal that has fat in it. 3. Keep meals low in fat to avoid oily stools. 4. A multivitamin at bedtime. 5. Under 5% lost at 12 weeks: stop. How much One capsule a fatty meal When Up to three a day How long Judge at 12 weeks Standard practice 120 mg three times a day with each main meal containing fat. Keep fat to about 30% of calories, and take a multivitamin at least 2 hours apart. The 60 mg dose is sold in UK pharmacies; stop at 12 weeks if 5% has not been lost. What happened in the studies 13lb(5.8 kg) off over 4 years Over 4 years, orlistat took off 13 lb (5.8 kg) against 6.5 lb (3.0 kg) on a dummy pill, and new diabetes fell. ¹ Diabetes care, 2004\. The study is under The science, below. Watch out Not with gut absorption problems, cholestasis or a transplant. Oily, urgent stools after fatty meals: keep meals low in fat. A multivitamin at bedtime. Yellow skin or eyes, dark pee or itching: stop and get seen. Kidney stones and gallstones can occur. It changes warfarin, thyroid, seizure and HIV medicines: tell the pharmacist everything you take. The science In detail For fat to lose alongside the deficit, from a pharmacy. One capsule with each main meal that contains fat, up to three a day, during or within an hour of the meal. No fat in the meal, skip the capsule. The 60 mg capsule is sold in pharmacies in the UK and over the counter in the US; the 120 mg is prescription. Under 5% lost at 12 weeks: stop. The full plan: [Weight loss injections and surgery](https://elonmuscular.com/protocol-weight-medicine/). Found **13 lb (5.8 kg) against 3.0 over 4 years.** Over 4 years, orlistat with lifestyle took off 13 lb (5.8 kg) against 6.5 lb (3.0 kg) on a dummy pill with lifestyle. New diabetes fell from 9.0% to 6.2%, a 37.3% drop in risk. Why It blocks the gut enzyme that breaks down fat, so about a third of the fat you eat passes straight through. It works in the gut and barely enters the blood. Watch Never with chronic malabsorption or cholestasis, or with cyclosporine after an organ transplant. Oily spotting, gas with discharge, and urgent or leaky stools, worse after a fatty meal: keep fat to about 30% of calories, spread over three meals. A multivitamin with A, D, E and K once a day, at least 2 hours from the capsule, such as at bedtime. Rare severe liver injury: itching, yellow eyes or skin, dark pee, pale stools or loss of appetite, stop it and get seen. Kidney stones and kidney injury from oxalate. Gallstones with fast loss. It changes warfarin, levothyroxine (take them 4 hours apart), cyclosporine, amiodarone, seizure medicines and HIV medicines. Severe belly pain that will not go: get seen. #### The study Mean weight loss after 4 years was significantly greater with orlistat (5.8 vs. 3.0 kg with placebo; P < 0.001) [PMID 14693982](https://pubmed.ncbi.nlm.nih.gov/14693982/?ref=elonmuscular.com) · XENical in the prevention of diabetes in obese subjects (XENDOS) study: a randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients. · Diabetes care, 2004 The sentence around it Mean weight loss after 4 years was significantly greater with orlistat (5.8 vs. 3.0 kg with placebo; P < 0.001) and similar between orlistat recipients with impaired (5.7 kg) or normal glucose tolerance (NGT) (5.8 kg) at baseline.… After 4 years' treatment, the cumulative incidence of diabetes was 9.0% with placebo and 6.2% with orlistat, corresponding to a risk reduction of 37.3% (P = 0.0032). The sentence around it After 4 years' treatment, the cumulative incidence of diabetes was 9.0% with placebo and 6.2% with orlistat, corresponding to a risk reduction of 37.3% (P = 0.0032). ### Next steps 17A lot to lose first: start with the bellyA long way to go: the first 5 to 10% firstStrong evidence ### A lot to lose first: start with the belly For: A lot to lose A long way from abs? Start by losing the first 5 to 10% of your weight, lifting all the way. #### What to do 1. Lift and hit the protein from day one. 2. Lose up to 1% a week. 3. Judge the waist at 12 weeks, then slow down as you get leaner. How much Up to 1% a week When From the start How long The first 12 weeks Standard practice Losing 5 to 10% of your body weight can improve your health. A waist over half your height: see your doctor for help. What happened in the studies Body fat down 1.46 points Across 58 studies, lifting alone cut body fat by 1.46 points and took off visceral fat. ¹ Sports medicine (Auckland, N.Z.), 2022\. The study is under The science, below. The science In detail Beer belly or dad bod, a long way from abs? The same plan, with more room: the fast end of the pace, 1% a week, while the lifting and protein hold the muscle. Aim for the first 5 to 10% of body weight, then judge the waist. New to lifting? See [First muscle](https://elonmuscular.com/protocol-first-muscle/). Soft at a normal weight? See [Body recomposition](https://elonmuscular.com/protocol-body-recomp/). Found **The first 5 to 10%.** 58 studies, lifting against no exercise: body fat percentage fell 1.46 points and visceral fat came down too. 34 trials of eating less: exercise prevented nearly half the lean mass loss. Why With more fat to lose, the body gives it up more easily and spares muscle better, so a faster pace keeps the muscle well. The belly fat that goes first is the kind that raises blood sugar and blood fats. #### The studies Compared to the control, resistance training reduced body fat percentage by - 1.46% (95% confidence interval - 1.78 to - 1.14, p < 0.0001), body fat mass by - 0.55 kg (95% confidence interval - 0.75 to - 0.34, p < 0.0001) and visceral fat by a standardised mean difference of - 0.49 (95% confidence interval - 0.87 to - 0.11, p = 0.0114). [PMID 34536199](https://pubmed.ncbi.nlm.nih.gov/34536199/?ref=elonmuscular.com) · The Effect of Resistance Training in Healthy Adults on Body Fat Percentage, Fat Mass and Visceral Fat: A Systematic Review and Meta-Analysis. · Sports medicine (Auckland, N.Z.), 2022 The sentence around it Compared to the control, resistance training reduced body fat percentage by - 1.46% (95% confidence interval - 1.78 to - 1.14, p < 0.0001), body fat mass by - 0.55 kg (95% confidence interval - 0.75 to - 0.34, p < 0.0001) and visceral fat by a standardised mean difference of - 0.49 (95% confidence interval - 0.87 to - 0.11, p = 0.0114). On average, EX prevented nearly half of FFM loss (45.7%). [PMID 42144246](https://pubmed.ncbi.nlm.nih.gov/42144246/?ref=elonmuscular.com) · Effects of Calorie Restriction With and Without Strength, Endurance or Mixed Training on Fat-Free and Skeletal Muscle Mass in Overweight or Obese Individuals-A Systematic Review With Pairwise Meta-Analysis and Network Meta-Analysis of Randomized Controlled Studies. · Diabetes, obesity & metabolism, 2026 The sentence around it On average, EX prevented nearly half of FFM loss (45.7%). 18After the cut: ease the food back upAbs showing: stop and ease food back upModerate evidence ### After the cut: ease the food back up For: The end of a cut Once your abs show, stop cutting and add food back slowly. Settle at a level you can keep. #### What to do 1. Abs showing? Stop the cut. 2. Add food back over a few weeks, mostly carbs. 3. Keep the protein and the lifting. Hold the waist. How much A little more each week When Once the abs show How long A few weeks, then hold What happened in the studies Testosterone came back At the end of a long cut, testosterone fell to 2.27 ng/mL. As food came back up it returned to 9.91 ng/mL. ¹ International journal of sports physiology and performance, 2013\. The study is under The science, below. Watch out Bingeing after the cut is common. More than once? See your doctor. The science In detail Abs showing? Stop cutting. Add food back gradually over a few weeks, mostly carbs, until the weekly average holds steady, and keep the protein and the lifting. Settle a little above your leanest, at a level you can live at. A few pounds of water and glycogen come back in week one; that is not fat. Found **Testosterone back after the cut.** The review of lean-physique nutrition: gradual returns to off-season intakes and body compositions you can hold, with support close by. One cut tracked for a year: at the leanest point testosterone had fallen from 9.22 to 2.27 ng/mL, and it returned to 9.91 as he ate back up. Why At the end of a cut, hunger is high and the burn is low, so a sudden return to old eating overshoots. A gradual climb lets the burn and the hormones recover while the waist holds. Watch Bingeing once the cut ends is common. If it happens more than once, see the body-image check. #### The studies Testosterone declined from 9.22 to 2.27 ng/mL during preparation and returned back to the baseline level, 9.91 ng/mL, after competition. [PMID 23412685](https://pubmed.ncbi.nlm.nih.gov/23412685/?ref=elonmuscular.com) · Natural bodybuilding competition preparation and recovery: a 12-month case study. · International journal of sports physiology and performance, 2013 The sentence around it Testosterone declined from 9.22 to 2.27 ng/mL during preparation and returned back to the baseline level, 9.91 ng/mL, after competition. In our narrative review we cover each factor, concluding with tentative best-practice recommendations, including dietary flexibility, slower weight loss, structured monitoring, gradual returns to offseason energy intakes, internal eating cues, appropriate offseason body compositions, and support from nutrition and mental health professionals. [PMID 31315180](https://pubmed.ncbi.nlm.nih.gov/31315180/?ref=elonmuscular.com) · Towards a Sustainable Nutrition Paradigm in Physique Sport: A Narrative Review. · Sports (Basel, Switzerland), 2019 The sentence around it In our narrative review we cover each factor, concluding with tentative best-practice recommendations, including dietary flexibility, slower weight loss, structured monitoring, gradual returns to offseason energy intakes, internal eating cues, appropriate offseason body compositions, and support from nutrition and mental health professionals. ### Early research 19Two refeed days a weekOptional: two carb days a week at maintenanceEarly evidence ### Two refeed days a week For: Long cuts Two higher-carb days a week kept more muscle during a diet in one trial. #### What to do 1. Diet 5 days. 2. Two days in a row at maintenance, extra food from carbs. 3. Train hard on or after those days. How much 2 days a week When Every week How long 7 weeks, then judge What happened in the studies Muscle kept better Two carb refeed days a week kept muscle and resting burn better than dieting every day. ¹ Journal of functional morphology and kinesiology, 2020\. The study is under The science, below. Watch out The scale goes up a little after. Check the weekly average. The science In detail Early research: diet five days a week, then two days in a row at about maintenance, with the extra food coming from carbs. The weekly average still falls. Lift on or right after the refeed days. Found **Lean mass kept better.** A 7-week trial with 4 lifting days a week: two carb refeed days a week lost fat like the continuous diet, and kept fat-free mass and resting burn better. Continuous dieters lost 3 lb (1.3 kg) of fat-free mass; refeeders, 0.9 lb (0.4 kg). Why Two days of carbs refill the muscle's glycogen and ease the drop in resting burn and in the hormones that follow a long deficit. Watch The scale jumps after refeed days with water and carbs. Read the weekly average and the tape. #### The study RF implemented two consecutive days of elevated carbohydrate (CHO) intake, followed by 5-days of caloric restriction each week. [PMID 33467235](https://pubmed.ncbi.nlm.nih.gov/33467235/?ref=elonmuscular.com) · Intermittent Energy Restriction Attenuates the Loss of Fat Free Mass in Resistance Trained Individuals. A Randomized Controlled Trial. · Journal of functional morphology and kinesiology, 2020 The sentence around it RF implemented two consecutive days of elevated carbohydrate (CHO) intake, followed by 5-days of caloric restriction each week. were better maintained in the RF group. The sentence around it were better maintained in the RF group. 20A one-week diet breakA week at maintenance after a long blockEarly evidence ### A one-week diet break For: Long cuts A week of normal eating after a long diet eased hunger and added a little lean mass in one trial. #### What to do 1. After about 12 weeks of dieting. 2. One week at maintenance, mostly extra carbs. 3. Then back to the cut. How much One week When After a long block How long One week What happened in the studies Less hunger, lean mass up One week at maintenance added 1.5 lb (0.7 kg) of lean mass and cut hunger and irritability. ¹ PloS one, 2021\. The study is under The science, below. Watch out The scale goes up a little from water. Check the waist. The science In detail Early research: after a long block of dieting, eat at maintenance for one week, mostly by adding carbs. Then go back to the cut. Time it for when hunger is at its worst. Found **1.5 lb (0.7 kg) more fat-free mass.** After 12 weeks of dieting: a week at maintenance added 1.5 lb (0.7 kg) of fat-free mass, improved leg endurance and alertness, and cut hunger and irritability. Why A long deficit turns up hunger and turns down the resting burn. A week of full food eases both, and makes the next block easier to hold. Watch The scale jumps a little with the carbs and water. Read the tape. #### The study In summary, a 1-week diet break improved muscle endurance in the legs and increased mental alertness, and reduced appetite and irritability. [PMID 33630880](https://pubmed.ncbi.nlm.nih.gov/33630880/?ref=elonmuscular.com) · A 1-week diet break improves muscle endurance during an intermittent dieting regime in adult athletes: A pre-specified secondary analysis of the ICECAP trial. · PloS one, 2021 The sentence around it In summary, a 1-week diet break improved muscle endurance in the legs and increased mental alertness, and reduced appetite and irritability. fat-free mass (0.7 kg, P<0.001) The sentence around it fat-free mass (0.7 kg, P<0.001) and in resting energy expenditure, from a mean (and 95% confidence interval) of 7000 (6420 to 7580) kJ/day to 7200 (6620 to 7780) kJ/day (P = 0.026).… 21Two weeks on, two weeks offOptional: 2 weeks on, 2 weeks at maintenanceEarly evidence ### Two weeks on, two weeks off For: A lot to lose Two weeks of dieting, then two weeks of normal eating, lost more fat in one trial. #### What to do 1. Two weeks in a deficit. 2. Two weeks at maintenance. 3. Repeat until the abs show. How much 2 on, 2 off When In pairs of blocks How long The whole cut What happened in the studies More fat lost In a 30-week trial, 2 weeks on and 2 off lost 27 lb (12.3 kg) of fat against 18 lb (8.0 kg) dieting straight through. ¹ International journal of obesity (2005), 2018\. The study is under The science, below. Watch out It makes the cut take twice as long. The science In detail Early research, for a long cut: diet for 2 weeks, then eat at maintenance for 2 weeks, and repeat. It takes longer on the calendar, and in the trial more fat came off. Found **27 lb (12.3 kg) against 18 lb (8.0 kg) of fat.** A 30-week trial: 2-week diet blocks with 2-week breaks at maintenance lost more fat, 27 lb (12.3 kg) against 18 lb (8.0 kg) dieting straight through, with a matched loss of fat-free mass. The resting burn fell less. Why Breaks at maintenance may reduce the body's push-back, the drop in resting burn that makes a long diet stall. Watch It doubles the time the cut takes. Only worth it if you have a lot to lose and the time to do it. #### The study Conclusions Greater weight and fat loss was achieved with intermittent ER. [PMID 28925405](https://pubmed.ncbi.nlm.nih.gov/28925405/?ref=elonmuscular.com) · Intermittent energy restriction improves weight loss efficiency in obese men: the MATADOR study. · International journal of obesity (2005), 2018 The sentence around it Conclusions Greater weight and fat loss was achieved with intermittent ER. INT had greater FM loss (12.3±4.8 vs 8.0±4.2 kg; P<0.01) The sentence around it INT had greater FM loss (12.3±4.8 vs 8.0±4.2 kg; P<0.01) 22HMBAbout 3 g of HMB a day while cuttingEarly evidence ### HMB during the cut For: An early extra An extra that, in one trial, kept muscle and took off more fat during a diet. #### What to do 1. About 3 grams a day. 2. Split it with meals. 3. Judge it on the tape and the log after 12 weeks. How much About 3 grams When Daily How long 12 weeks What happened in the studies Muscle kept, more fat off In a 12-week diet trial, HMB with protein kept muscle and took off more fat, belly fat included. ¹ Journal of cachexia, sarcopenia and muscle, 2026\. The study is under The science, below. Watch out Mild stomach upset. The science In detail Early research: about 3 g of HMB a day while you eat less, as an extra beside the protein, never in place of it. Found A 12-week dieting trial: a daily drink with 3 g of HMB and 24 g of protein kept skeletal muscle and took more fat off, visceral fat included. The HMB position stand: 38 mg per kilo (17 mg per lb) a day with training may improve body composition. Why HMB is made in the body from leucine and works mainly by holding back muscle breakdown, which is the risk when food is short. Watch Mild stomach upset. The trial drink carried protein too, so part of the effect may be the protein. #### The studies During dietary weight loss, CaHMB-enriched supplementation preserved SMM and produced greater visceral and total fat reductions. [PMID 42444106](https://pubmed.ncbi.nlm.nih.gov/42444106/?ref=elonmuscular.com) · Calcium Beta-Hydroxy-Beta-Methylbutyrate-Enriched Nutritional Supplementation During Dietary Weight Loss in Adults With Obesity: A Randomized Controlled Trial. · Journal of cachexia, sarcopenia and muscle, 2026 The sentence around it …Conclusions During dietary weight loss, CaHMB-enriched supplementation preserved SMM and produced greater visceral and total fat reductions. Daily HMB supplementation (38 mg/kg body weight) in combination with exercise training may improve body composition through increasing lean mass and/or decreasing fat mass [PMID 39699070](https://pubmed.ncbi.nlm.nih.gov/39699070/?ref=elonmuscular.com) · International society of sports nutrition position stand: β-hydroxy-β-methylbutyrate (HMB). · Journal of the International Society of Sports Nutrition, 2025 The sentence around it Daily HMB supplementation (38 mg/kg body weight) in combination with exercise training may improve body composition through increasing lean mass and/or decreasing fat mass [The deep dive on this](https://elonmuscular.com/hmb/) 23Beta-AlanineOptional: 4 to 6 g a day, splitEarly evidence ### Beta-alanine, for the hard sessions For: Hard sessions An extra that helps hard efforts of a few minutes, so training stays strong while you cut. #### What to do 1. 4 to 6 grams a day. 2. In doses of about 1.6 grams, spread out. 3. Give it at least 4 weeks. How much 4 to 6 grams When Split through the day How long 4 weeks or more What happened in the studies Harder efforts, 1 to 4 minutes Across 15 papers, beta-alanine improved efforts of 60 to 240 seconds, 1 to 4 minutes. ¹ Amino acids, 2012\. The study is under The science, below. Watch out Tingling skin. Smaller split doses help. The science In detail Early research for this goal: 4 to 6 g of beta-alanine a day, in doses of about 1.6 g spread through the day, for at least 4 weeks. It helps hard efforts of 1 to 4 minutes, so sessions stay strong on less food. Found **Efforts of 1 to 4 minutes.** A review of 15 papers: beta-alanine improved efforts lasting 60 to 240 seconds, and longer ones too. A larger one of 40 studies found a clear overall effect on exercise. Why Beta-alanine builds carnosine in muscle, which buffers the acid that burns in a long hard set. Better sessions keep the signal to hold the muscle. Watch Tingling skin is the one reported side effect; smaller split doses of about 1.6 g cut it. #### The studies exercise lasting 60-240 s was improved (P=0.001) in BA compared to Pla, as was exercise of >240 s (P=0.046). [PMID 22270875](https://pubmed.ncbi.nlm.nih.gov/22270875/?ref=elonmuscular.com) · Effects of β-alanine supplementation on exercise performance: a meta-analysis. · Amino acids, 2012 The sentence around it …In line with the purported mechanisms for an ergogenic effect of β-alanine supplementation, exercise lasting 60-240 s was improved (P=0.001) in BA compared to Pla, as was exercise of >240 s (P=0.046). A significant overall effect size of 0.18 (95% CI 0.08 to 0.28) was shown. [PMID 27797728](https://pubmed.ncbi.nlm.nih.gov/27797728/?ref=elonmuscular.com) · β-alanine supplementation to improve exercise capacity and performance: a systematic review and meta-analysis. · British journal of sports medicine, 2017 The sentence around it A significant overall effect size of 0.18 (95% CI 0.08 to 0.28) was shown. [The deep dive on this](https://elonmuscular.com/beta-alanine/) 24An 8-hour eating windowOptional: eat inside an 8-hour windowEarly evidence ### An 8-hour eating window For: If it helps you eat less Eating inside an 8-hour window lost fat and kept muscle in one trial. #### What to do 1. Pick an 8-hour window, such as 1pm to 9pm. 2. Still hit the protein, in 3 meals. 3. Keep lifting as normal. How much 8 hours When Every day How long 8 weeks, then judge What happened in the studies Fat down, muscle held Over 8 weeks, an 8-hour eating window lost more fat while muscle and strength held. ¹ Journal of translational medicine, 2016\. The study is under The science, below. Watch out Testosterone dropped in the trial. Hitting the protein in fewer meals is harder. The science In detail Early research: if it suits you, eat all your food inside 8 hours a day, still hitting the protein and lifting as normal. It helps some men hold the deficit. Found An 8-week trial with lifting, calories matched: eating in an 8-hour window lost more fat mass. Fat-free mass, arm and thigh muscle and maximum strength held. Why A shorter eating day makes eating less easier for some. The fat loss rests on the calories, and the muscle on the lifting and the protein. Watch In the trial, testosterone fell on the eating window. Fitting 1 g per pound (2.2 g per kilo) of protein into fewer meals is harder. #### The study a decrease in fat mass in TRF compared to ND (p = 0.0448), while fat-free mass, muscle area of the arm and thigh, and maximal strength were maintained in both groups. [PMID 27737674](https://pubmed.ncbi.nlm.nih.gov/27737674/?ref=elonmuscular.com) · Effects of eight weeks of time-restricted feeding (16/8) on basal metabolism, maximal strength, body composition, inflammation, and cardiovascular risk factors in resistance-trained males. · Journal of translational medicine, 2016 The sentence around it …Results After 8 weeks, the 2 Way ANOVA (Time \* Diet interaction) showed a decrease in fat mass in TRF compared to ND (p = 0.0448), while fat-free mass, muscle area of the arm and thigh, and maximal strength were maintained in both groups. 25CapsaicinOptional: chili in your mealsEarly evidence ### Chili with meals For: More to lose Chili in your food burns a few more calories a day. A small extra, not a fix. #### What to do 1. Cook with chili most days. 2. Food, not pills. 3. Stop if it gives you heartburn. How much Chili in meals When With meals How long As long as you like it What happened in the studies About 58 calories a day Across 9 trials, capsaicin raised the daily burn by about 58 calories and shifted it toward fat. ¹ Critical reviews in food science and nutrition, 2018\. The study is under The science, below. Watch out It can cause heartburn or an upset stomach. The science In detail Early research, and a small effect: chili or capsaicin with meals. It adds a little to the daily burn and shifts it toward fat. Food first: chili in the cooking, not a cayenne pill. Found **About 58 calories a day more.** A review of 9 trials: after capsaicin or its mild cousins, energy spent rose by about 58 calories a day and the body burned a larger share of fat. Twenty trials, 563 people: regular chili cut belly fat, appetite and the food eaten. Why Capsaicin opens the heat receptor TRPV1, which nudges the nervous system to burn a little more energy and more of it as fat. Watch Heartburn and a burning gut for some. Stop if it upsets your stomach. #### The studies Data analysis showed that after ingestion of capsaicin or capsinoids the energy expenditure increased (245 kJ/day, 58.56 kcal/day, p = 0.030) and the respiratory quotient decreased (by 0.216; p = 0.031) indicating a rise in fat oxidation. [PMID 28001433](https://pubmed.ncbi.nlm.nih.gov/28001433/?ref=elonmuscular.com) · Capsaicin and capsiate could be appropriate agents for treatment of obesity: A meta-analysis of human studies. · Critical reviews in food science and nutrition, 2018 The sentence around it Data analysis showed that after ingestion of capsaicin or capsinoids the energy expenditure increased (245 kJ/day, 58.56 kcal/day, p = 0.030) and the respiratory quotient decreased (by 0.216; p = 0.031) indicating a rise in fat oxidation. regular consumption significantly reduced abdominal adipose tissue levels and reduced appetite and energy intake [PMID 22634197](https://pubmed.ncbi.nlm.nih.gov/22634197/?ref=elonmuscular.com) · Capsaicinoids and capsinoids. A potential role for weight management? A systematic review of the evidence. · Appetite, 2012 The sentence around it …It was also observed that regular consumption significantly reduced abdominal adipose tissue levels and reduced appetite and energy intake.… [The deep dive on this](https://elonmuscular.com/capsaicin/) 26L-CarnitineL-carnitine, 2,000 mg a dayEarly evidence ### L-carnitine, 2,000 mg a day For: An early extra A supplement that took a little weight and fat off in 37 trials. Early research. #### What to do 1. Take 2,000 mg of L-carnitine a day, with food. 2. Keep the deficit and the lifting going. 3. Stop if you get a fishy smell or stomach upset. How much 2,000 mg When Daily How long The whole cut What happened in the studies 4.5lb(2.08 kg) less fat Across 37 trials, carnitine took about 2.5 lb (1.2 kg) off body weight and 4.5 lb (2.08 kg) off fat mass. ¹ Clinical nutrition ESPEN, 2020\. The study is under The science, below. Watch out Stomach upset and a fishy smell. Heart disease, epilepsy, kidney disease, thyroid medicine or a blood thinner: ask a doctor first. The science In detail Early research: 2,000 mg of L-carnitine a day with food, the dose where the pooled effect peaked. An extra beside the deficit, never instead of it. Found **4.5 lb (2.08 kg) of fat off, 37 trials.** 37 trials, 2,292 people: carnitine took 2.5 lb (1.21 kg) off body weight and 4.5 lb (2.08 kg) off fat mass against control. The effect peaked at about 2,000 mg a day. Why Carnitine carries fatty acids into the mitochondria, the part of the cell that burns them for energy. Watch Stomach upset, nausea and a fishy body or breath smell, more at higher doses. It raises TMAO, a gut-made compound linked to artery disease: with heart disease, ask a doctor first. It can raise seizure frequency: with epilepsy, ask first. It may blunt thyroid hormone and add to the effect of warfarin: on thyroid medicine or a blood thinner, ask first. With kidney disease, ask first. The doses the studies used**2,000 mg a day** *where the pooled effect on weight peaked* 2,000 mg a day ingestion of 2000 mg l-carnitine per day provides the maximum effect [PMID 32359762](https://pubmed.ncbi.nlm.nih.gov/32359762/?ref=elonmuscular.com) #### The study l-carnitine supplementation significantly decreased body weight \[Weighted mean difference (WMD) = -1.21 kg, 95% confidence interval (CI): -1.73, -0.68; P < 0.001\], body mass index (BMI) (WMD = -0.24 kg/m 2 , 95% CI: -0.37, -0.10; P = 0.001), and fat mass (WMD = -2.08 kg, 95% CI: -3.44, -0.72; P = 0.003). [PMID 32359762](https://pubmed.ncbi.nlm.nih.gov/32359762/?ref=elonmuscular.com) · Effects of l-carnitine supplementation on weight loss and body composition: A systematic review and meta-analysis of 37 randomized controlled clinical trials with dose-response analysis. · Clinical nutrition ESPEN, 2020 The sentence around it …Meta-analysis showed that l-carnitine supplementation significantly decreased body weight \[Weighted mean difference (WMD) = -1.21 kg, 95% confidence interval (CI): -1.73, -0.68; P < 0.001\], body mass index (BMI) (WMD = -0.24 kg/m 2 , 95% CI: -0.37, -0.10; P = 0.001), and fat mass (WMD = -2.08 kg, 95% CI: -3.44, -0.72; P = 0.003). [The deep dive on this](https://elonmuscular.com/l-carnitine/) 27Green TeaGreen tea, the drink, not the extractEarly evidence ### Green tea, the drink For: Tea drinkers Green tea helps a little with losing weight and keeping it off. The drink, not the pills. #### What to do 1. Drink 3 or 4 cups of green tea a day. 2. Have the last one before mid-afternoon. 3. Stick to the tea, not strong extract pills. How much 3 or 4 cups When Before mid-afternoon How long Every day What happened in the studies 3lb(1.31 kg) off Across 11 studies, green tea compounds took 3 lb (1.31 kg) off and helped keep it off. ¹ International journal of obesity (2005), 2009\. The study is under The science, below. Watch out Strong green tea extract pills can injure the liver. Late caffeine hurts your sleep. Drink it between meals, and not scalding hot. The science In detail Early research: 3 or 4 cups of brewed green tea a day, the last one before mid-afternoon. The drink, never a concentrated extract pill. Found **3 lb (1.31 kg), 11 trials.** Eleven studies pooled: green tea catechins took weight off, and helped keep it off after a diet, by 3 lb (1.31 kg). The authors call it a small positive effect on losing weight and keeping it off. Why The catechins and the caffeine together raise heat production and fat burning for a few hours. The effect is small and adds up daily. Watch The drink only: concentrated green tea extract pills have injured livers. Caffeine late in the day takes from sleep. The tannins cut iron absorption from food: drink it between meals. Very hot tea is linked to cancer of the food pipe: let it cool a little. It can change how some medicines work: on regular medicines, ask a pharmacist. #### The study Catechins significantly decreased body weight and significantly maintained body weight after a period of WL (microcirc=-1.31 kg; P<0.001). [PMID 19597519](https://pubmed.ncbi.nlm.nih.gov/19597519/?ref=elonmuscular.com) · The effects of green tea on weight loss and weight maintenance: a meta-analysis. · International journal of obesity (2005), 2009 The sentence around it …Results Catechins significantly decreased body weight and significantly maintained body weight after a period of WL (microcirc=-1.31 kg; P<0.001). Catechins or an epigallocatechin gallate (EGCG)-caffeine mixture have a small positive effect on WL and WM. The sentence around it …Conclusions Catechins or an epigallocatechin gallate (EGCG)-caffeine mixture have a small positive effect on WL and WM. [The deep dive on this](https://elonmuscular.com/green-tea/) 28Medium-Chain TriglyceridesMCT oil in place of other fatsEarly evidence ### MCT oil in place of other fats For: Swapping your oils Swapping some cooking fat for MCT oil took a little weight and waist off in trials. Early research. #### What to do 1. Swap some cooking fat for MCT oil. 2. Build up to 18 to 24 grams a day. 3. Never add it on top of your other fats. How much 18 to 24 g When With meals How long 16 weeks in the trial What happened in the studies 0.6in (1.46 cm) off the waist In 13 trials with 749 people, MCT in place of other fats took 1 lb (0.51 kg) and 0.6 in (1.46 cm) off the waist. ¹ Journal of the Academy of Nutrition and Dietetics, 2015\. The study is under The science, below. Watch out Stomach upset if you start high. It can raise cholesterol, so recheck it. A swap, not an extra. Diabetes or liver disease: ask first. The science In detail Early research: swap some of your cooking fat for MCT oil, 18 to 24 g a day as in the trial. Swap it, never add it on top. Start small and build up. Found Thirteen trials, 749 people: in place of ordinary fats, MCT took 1 lb (0.51 kg) off body weight and 0.6 in (1.46 cm) off the waist. Total and visceral fat fell too. A 16-week weight-loss trial: 18 to 24 g a day of MCT oil ended 3.5 lb (1.67 kg) lighter than olive oil. Why Medium-chain fats go straight to the liver and are burned fast, so less is stored and a little more energy is spent. Watch Gut upset, cramps and diarrhea if you start high: build up slowly. It can raise cholesterol in some: recheck your lipids. It is still fat, full of calories: it only helps as a swap. With poorly controlled diabetes or liver disease, ask a doctor first. The doses the studies used**18 to 24 g a day** *the 16-week trial's dose, in place of olive oil* 18 to 24 g a day 18-24 g/d of MCT oil [PMID 18326600](https://pubmed.ncbi.nlm.nih.gov/18326600/?ref=elonmuscular.com) #### The studies Compared with LCTs, MCTs decreased body weight (-0.51 kg \[95% CI-0.80 to -0.23 kg\]; P<0.001; I(2)=35%); waist circumference (-1.46 cm \[95% CI -2.04 to -0.87 cm\]; P<0.001; I(2)=0%) [PMID 25636220](https://pubmed.ncbi.nlm.nih.gov/25636220/?ref=elonmuscular.com) · Effects of medium-chain triglycerides on weight loss and body composition: a meta-analysis of randomized controlled trials. · Journal of the Academy of Nutrition and Dietetics, 2015 The sentence around it Compared with LCTs, MCTs decreased body weight (-0.51 kg \[95% CI-0.80 to -0.23 kg\]; P<0.001; I(2)=35%); waist circumference (-1.46 cm \[95% CI -2.04 to -0.87 cm\]; P<0.001; I(2)=0%), hip circumference (-0.79 cm \[95% CI -1.27 to -0.30 cm\]; P=0.002; I(2)=0%), total body fat (standard mean difference -0.39 \[95% CI -0.57 to -0.22\]; P<0.001; I(2)=0%), total subcutaneous fat (standard mean difference -0.46 \[95% CI -0.64 to -0.27\]; P<0.001; I(2)=20%), and visceral fat (standard mean … MCT oil consumption resulted in lower endpoint body weight than did olive oil (-1.67 +/- 0.67 kg, unadjusted P = 0.013). [PMID 18326600](https://pubmed.ncbi.nlm.nih.gov/18326600/?ref=elonmuscular.com) · Weight-loss diet that includes consumption of medium-chain triacylglycerol oil leads to a greater rate of weight and fat mass loss than does olive oil. · The American journal of clinical nutrition, 2008 The sentence around it MCT oil consumption resulted in lower endpoint body weight than did olive oil (-1.67 +/- 0.67 kg, unadjusted P = 0.013). [The deep dive on this](https://elonmuscular.com/medium-chain-triglycerides/) 29Apple Cider Vinegar15 mL of vinegar a day, diluted, with a mealEarly evidence ### Vinegar with meals For: An early extra A spoon of vinegar in water with a meal took a little weight and waist off in a 12-week trial. Early research. #### What to do 1. Mix 15 mL of vinegar into a large glass of water. 2. Drink it with a meal, through a straw. 3. Rinse your mouth after. How much 15 mL When With a meal How long 12 weeks What happened in the studies Weight and waist down In a 12-week trial, 15 or 30 mL of vinegar a day lowered weight, waist and belly fat against a dummy drink. ¹ Bioscience, biotechnology, and biochemistry, 2009\. The study is under The science, below. Watch out Never neat: it hurts teeth and throat. Use a straw and rinse. On diabetes drugs or water pills, or with kidney disease: ask first. The science In detail Early research: 15 mL of vinegar a day, about a tablespoon, diluted in a large glass of water with a meal. The trial also tested 30 mL. Drink it through a straw and rinse after. Found **Weight and waist down in 12 weeks.** A 12-week trial: 15 or 30 mL of vinegar a day, in a 17 fl oz (500 mL) drink, lowered body weight, BMI, visceral fat, waist and triglycerides against placebo. Ten trials pooled: a daily vinegar drink took weight and waist down. Why Acetic acid, the acid in vinegar, curbed fat build-up in animal studies. It also slows how fast a meal leaves the stomach. Watch Never neat: it erodes tooth enamel and can burn the throat. Dilute it, use a straw and rinse your mouth after. It slows stomach emptying, which matters if your stomach already empties slowly. With insulin or other diabetes drugs, blood sugar can drop. Large amounts over time can lower potassium: on water pills, ask a doctor first. With advanced kidney disease, ask first. The doses the studies used**15 mL a day** *the lower trial dose, 12 weeks* 15 mL a day30 mL a day 15 ml of vinegar (750 mg AcOH) [PMID 19661687](https://pubmed.ncbi.nlm.nih.gov/19661687/?ref=elonmuscular.com) #### The studies Body weight, BMI, visceral fat area, waist circumference, and serum triglyceride levels were significantly lower in both vinegar intake groups than in the placebo group. [PMID 19661687](https://pubmed.ncbi.nlm.nih.gov/19661687/?ref=elonmuscular.com) · Vinegar intake reduces body weight, body fat mass, and serum triglyceride levels in obese Japanese subjects. · Bioscience, biotechnology, and biochemistry, 2009 The sentence around it Body weight, BMI, visceral fat area, waist circumference, and serum triglyceride levels were significantly lower in both vinegar intake groups than in the placebo group. daily ACV intake significantly reduced body weight \[SMD: -0.39; 95% CI: -0.63, -0.15; p = 0.001; I 2 = 62%\], BMI \[SMD: -0.65; 95% CI: -1.05, -0.26; p = 0.001; I 2 = 83%\], and WC \[SMD: -0.34; 95% CI: -0.67, -0.02; p = 0.04; I 2 = 61%\]. [PMID 41010525](https://pubmed.ncbi.nlm.nih.gov/41010525/?ref=elonmuscular.com) · Effect of Apple Cider Vinegar Intake on Body Composition in Humans with Type 2 Diabetes and/or Overweight: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. · Nutrients, 2025 The sentence around it …The pooled results using a random-effects model showed that daily ACV intake significantly reduced body weight \[SMD: -0.39; 95% CI: -0.63, -0.15; p = 0.001; I 2 = 62%\], BMI \[SMD: -0.65; 95% CI: -1.05, -0.26; p = 0.001; I 2 = 83%\], and WC \[SMD: -0.34; 95% CI: -0.67, -0.02; p = 0.04; I 2 = 61%\]. [The deep dive on this](https://elonmuscular.com/apple-cider-vinegar/) 30OleoylethanolamideOEA, 125 to 250 mg a dayEarly evidence ### OEA, for hunger on the cut For: Hungry on the cut A fat the gut makes after meals that tells you that you are full. In pooled trials, weight and waist came down. #### What to do 1. Take 125 to 250 mg a day, before meals. 2. Give it 8 weeks. 3. Judge it on the tape and the weekly average. How much 125 to 250 mg When Before meals How long 8 weeks, then judge What happened in the studies Waist down about 0.8 in (2 cm) Across 10 trials, OEA brought weight, waist and body fat down. ¹ Frontiers in nutrition, 2025\. The study is under The science, below. Watch out Mild stomach upset in some. The science In detail Early research: 125 to 250 mg of OEA a day, before meals, the doses the trials used, for 8 weeks. Beside the deficit and the protein, never in place of them. Found **Waist about 0.8 in (2 cm) smaller.** Ten trials pooled: weight, waist, fat mass and body fat percentage all fell on OEA. Thirteen studies: the waist came in by about 0.8 in (2 cm). Why OEA is a fat the gut makes after a meal. It signals fullness to the brain, so the deficit is easier to hold. Watch Mild gut upset in some. The trial doses**250 mg** *a day as two 125 mg capsules, eight weeks* 250 mg received two capsules containing 125 mg of OEA daily [PMID 31132422](https://pubmed.ncbi.nlm.nih.gov/31132422/?ref=elonmuscular.com) #### The studies Meta-analysis revealed that OEA supplementation led to a significant improvement in C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), total antioxidant capacity (TAC), malondialdehyde (MDA), body weight, body mass index (BMI), waist circumference (WC), fat mass (FM), body fat percentage (BFP) [PMID 40469682](https://pubmed.ncbi.nlm.nih.gov/40469682/?ref=elonmuscular.com) · Oleoylethanolamide supplementation on cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials. · Frontiers in nutrition, 2025 The sentence around it Meta-analysis revealed that OEA supplementation led to a significant improvement in C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), total antioxidant capacity (TAC), malondialdehyde (MDA), body weight, body mass index (BMI), waist circumference (WC), fat mass (FM), body fat percentage (BFP), triglycerides (TG), fasting blood glucose (FBG), insulin, and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) levels.… Data from 13 studies indicated substantial reductions in fasting blood sugar (WMD: -5.84 mg/dl), insulin (WMD: -3.26 µU/ml), waist circumference (WMD: -2.15 cm), triglycerides (WMD: -17.73 mg/dl) [PMID 40661161](https://pubmed.ncbi.nlm.nih.gov/40661161/?ref=elonmuscular.com) · The effect of oleoylethanolamide supplementation on cardiometabolic factors: a systematic review and meta-analysis. · Cardiovascular endocrinology & metabolism, 2025 The sentence around it Data from 13 studies indicated substantial reductions in fasting blood sugar (WMD: -5.84 mg/dl), insulin (WMD: -3.26 µU/ml), waist circumference (WMD: -2.15 cm), triglycerides (WMD: -17.73 mg/dl), tumor necrosis factor-alpha (WMD: -2.44 pg/ml), and interleukin 6 (WMD: -0.87 pg/ml).… [The deep dive on this](https://elonmuscular.com/oleoylethanolamide/) 31ThylakoidsThylakoids, 5 g before the main mealEarly evidence ### Thylakoids, for hunger before a meal For: Hungry on the cut A spinach extract taken before a meal. In pooled trials it cut hunger and made people feel full longer. #### What to do 1. Stir 5 g into water. 2. Drink it 30 minutes before the main meal. 3. Judge it on your hunger inside 8 weeks. How much 5 g When Before the main meal How long Up to 8 weeks, then judge What happened in the studies Less hunger In pooled trials, hunger fell and fullness rose when thylakoids came with the meal. ¹ Nutrition reviews, 2025\. The study is under The science, below. Watch out Mild stomach upset in some. The science In detail Early research: 5 g of a spinach thylakoid extract a day, stirred into water 30 minutes before the main meal, the trials' dose. Beside the deficit, never in place of it. Found **Less hunger, more fullness.** Pooled trials: hunger fell and fullness rose when thylakoids came with the meal, most clearly in the first two months. Why Thylakoids are the green membranes in leaves. They slow how fast fat is digested, so the gut's fullness signals run longer. Watch Mild gut upset in some. The doses the studies used**5 g a day** *one packet, 30 minutes before lunch, for 12 weeks* 5 g a day 5 g/day of thylakoid-rich spinach extract [PMID 37576981](https://pubmed.ncbi.nlm.nih.gov/37576981/?ref=elonmuscular.com) #### The study a significant association between the combination of thylakoids with meals and reduced hunger (WMD: -2.415 mm; 95% CI: -3.544, -1.287; P < 0.001) and increased fullness (WMD: +4.602 mm; 95% CI: 2.356, 6.848; P < 0.001). [PMID 38518202](https://pubmed.ncbi.nlm.nih.gov/38518202/?ref=elonmuscular.com) · Thylakoid supplementation and hunger and fullness perception: a systematic review and dose-response meta-analysis of randomized controlled trials. · Nutrition reviews, 2025 The sentence around it …The meta-analysis also suggests a significant association between the combination of thylakoids with meals and reduced hunger (WMD: -2.415 mm; 95% CI: -3.544, -1.287; P < 0.001) and increased fullness (WMD: +4.602 mm; 95% CI: 2.356, 6.848; P < 0.001). [The deep dive on this](https://elonmuscular.com/thylakoids/) ### With a doctor Everything in this group is a decision for you and a doctor who has your bloodwork and your history. 32Tirzepatide: the strongest fat-loss shot, with a doctorA weekly shot, stepped up every 4 weeksModerate evidence ### Tirzepatide: the strongest fat-loss shot, with a doctor For: A lot of fat to lose A weekly shot that turns hunger right down. The biggest fat loss of any medicine: about a fifth of body weight. #### What to do 1. For a lot of fat to lose, on a prescription only, from a registered pharmacy. 2. Start at 2.5 mg a week; step up every 4 weeks at the fastest. 3. Keep lifting and keep the protein high. 4. Tell anyone sedating you that you take it. How much 2.5 mg to 15 mg a week When Once a week How long Long term Standard practice Starts at 2.5 mg once a week for 4 weeks, rising in 2.5 mg steps after at least 4 weeks. Keeps at 5, 10 or 15 mg. 15 mg is the maximum. What happened in the studies About a fifth of body weight off At 72 weeks, weight fell 20.9% on the top dose, against 3.1% on a dummy shot. ¹ The New England journal of medicine, 2022\. The study is under The science, below. Watch out Boxed warning: thyroid tumors in rats. Never with a personal or family history of medullary thyroid cancer or MEN 2, or after a serious allergy to it. A neck lump, trouble swallowing or a hoarse voice that lasts: tell the doctor. The dose climbs every 4 weeks at the fastest; sickness peaks during the climb. Kidney injury if sickness dries you out. Gallstones. Severe belly pain that will not go, maybe into the back, can be pancreatitis: stop and get seen. Allergic swelling of the face or throat: emergency. Low sugar with insulin or other diabetes pills. Diabetic eye disease can worsen. Tell anyone sedating you, as food can stay in the stomach. Warfarin gets checked more. Never share a pen. Never with another GLP-1 drug. Keep lifting and keep the protein up, or muscle goes with the fat. The science In detail For a lot of fat to lose, not the last few kilos: it is prescribed for obesity, or overweight with a weight-related condition. A weekly injection, on a prescription only, from a registered pharmacy: fake weight-loss pens are sold online. It starts at 2.5 mg a week for 4 weeks, rising by 2.5 mg no sooner than every 4 weeks, to 5, 10 or 15 mg. Keep lifting and keep the protein high the whole time. Prescription. The full plan is on [Weight loss injections and surgery](https://elonmuscular.com/protocol-weight-medicine/); keeping the muscle is [Muscle loss on GLP-1](https://elonmuscular.com/protocol-glp1-muscle/). Found **20.9% of body weight off.** At 72 weeks, weight fell 20.9% on 15 mg, 19.5% on 10 mg and 15.0% on 5 mg, against 3.1% on a dummy shot. Head to head, it took off 20.2% against 13.7% on semaglutide. Why Two gut hormones in one molecule, GLP-1 and GIP: appetite down, fullness up, the stomach slower. The fat comes off the whole body, belly included. The loss runs as long as the drug does. Watch The label's boxed warning: thyroid C-cell tumors in rats, so never with a personal or family history of medullary thyroid cancer or MEN 2\. A lump in the neck, trouble swallowing, breathlessness or a hoarse voice that lasts: tell the doctor. Never after a serious allergic reaction to it. The dose steps up no faster than every 4 weeks: sickness, vomiting and diarrhea peak during the steps and can be severe. Not with severe gastroparesis. Kidney injury when sickness or diarrhea dries you out, so kidney function is checked. Gallstones and gallbladder inflammation. Pancreatitis: severe belly pain that will not go, sometimes into the back, means stop it and get seen. Anaphylaxis and swelling of the face or throat. Low blood sugar, most with insulin or a sulfonylurea. Diabetic eye disease can get worse. Food can stay in the stomach under anesthesia or deep sedation: tell the team before any procedure. Tablets you swallow can absorb differently, so drugs such as warfarin are monitored. Never share a pen. Never with another GLP-1 drug. Muscle goes with the fat unless you keep lifting and keep the protein high: hold both the whole time. Weekly dose**15 mg** *20.9% off* 5 mg10 mg15 mg \-20.9% (95% CI, -21.8 to -19.9) with 15-mg doses [PMID 35658024](https://pubmed.ncbi.nlm.nih.gov/35658024/?ref=elonmuscular.com) #### The studies The mean percentage change in weight at week 72 was -15.0% (95% confidence interval \[CI\], -15.9 to -14.2) with 5-mg weekly doses of tirzepatide, -19.5% (95% CI, -20.4 to -18.5) with 10-mg doses, and -20.9% (95% CI, -21.8 to -19.9) with 15-mg doses and -3.1% (95% CI, -4.3 to -1.9) with placebo (P<0.001 for all comparisons with placebo). [PMID 35658024](https://pubmed.ncbi.nlm.nih.gov/35658024/?ref=elonmuscular.com) · Tirzepatide Once Weekly for the Treatment of Obesity. · The New England journal of medicine, 2022 The sentence around it The mean percentage change in weight at week 72 was -15.0% (95% confidence interval \[CI\], -15.9 to -14.2) with 5-mg weekly doses of tirzepatide, -19.5% (95% CI, -20.4 to -18.5) with 10-mg doses, and -20.9% (95% CI, -21.8 to -19.9) with 15-mg doses and -3.1% (95% CI, -4.3 to -1.9) with placebo (P<0.001 for all comparisons with placebo). The least-squares mean percent change in weight at week 72 was -20.2% (95% confidence interval \[CI\], -21.4 to -19.1) with tirzepatide and -13.7% (95% CI, -14.9 to -12.6) with semaglutide (P<0.001). [PMID 40353578](https://pubmed.ncbi.nlm.nih.gov/40353578/?ref=elonmuscular.com) · Tirzepatide as Compared with Semaglutide for the Treatment of Obesity. · The New England journal of medicine, 2025 The sentence around it The least-squares mean percent change in weight at week 72 was -20.2% (95% confidence interval \[CI\], -21.4 to -19.1) with tirzepatide and -13.7% (95% CI, -14.9 to -12.6) with semaglutide (P<0.001). [The deep dive on this](https://elonmuscular.com/tirzepatide/) 33Semaglutide: the weekly shot or daily tablet, with a doctorA weekly shot, stepped up every 4 weeks to 2.4 mgModerate evidence ### Semaglutide: the weekly shot or daily tablet, with a doctor For: A lot of fat to lose A weekly shot, or a daily tablet, that turns hunger down. About a seventh of body weight off. #### What to do 1. For a lot of fat to lose, on a prescription only, from a registered pharmacy. 2. The shot: 0.25 mg a week, stepping up every 4 weeks to 2.4 mg. 3. The tablet: 1.5 mg a day, then 4, 9 and 25 mg, a step every 30 days. 4. Keep lifting and keep the protein high. 5. Tell anyone sedating you that you take it. How much 0.25 to 2.4 mg a week, or a 25 mg tablet a day When Weekly shot, or a daily tablet How long Long term Standard practice Starts at 0.25 mg once a week, stepping up every 4 weeks; maintenance is 1.7 or 2.4 mg, up to 7.2 mg. A step not tolerated waits 4 weeks. The tablet starts at 1.5 mg daily for 30 days, then 4 and 9 mg, and keeps at 25 mg. Heart rate is checked at regular intervals. What happened in the studies 34lb(15.3 kg) off on average Over 68 weeks, semaglutide took off 14.9% of body weight, 34 lb (15.3 kg) on average, against 2.4% on a dummy shot. ¹ The New England journal of medicine, 2021\. The study is under The science, below. Watch out Boxed warning: thyroid tumors in rodents. Never with a personal or family history of medullary thyroid cancer or MEN 2, or after a serious allergy to it. A neck lump, trouble swallowing or a hoarse voice that lasts: tell the doctor. The dose climbs every 4 weeks. Severe belly pain that will not go, maybe into the back, can be pancreatitis: stop and get seen. Gallstones, low sugar with insulin or other diabetes pills, kidney injury if sickness dries you out, and severe gut side effects. Allergic swelling of the face or throat: emergency. Diabetic eye disease can worsen. Your resting heart rate rises: report a racing heart at rest. Tell anyone sedating you. The tablet can raise levothyroxine levels. Never share a pen. Sudden vision loss in one eye: urgent help. Keep lifting and keep the protein up, or muscle goes with the fat. The science In detail For a lot of fat to lose: it is prescribed for obesity, or overweight with a weight-related condition. A weekly injection or a daily tablet, on a prescription only, from a registered pharmacy. The shot starts at 0.25 mg a week and steps up every 4 weeks to 2.4 mg, or 1.7 mg if needed. It can go to 7.2 mg. The tablet starts at 1.5 mg a day, then 4 mg, then 9 mg, then 25 mg to keep, each step after 30 days. Keep lifting and keep the protein high the whole time. The shot and the tablet on prescription. The full plan is on [Weight loss injections and surgery](https://elonmuscular.com/protocol-weight-medicine/); keeping the muscle is [Muscle loss on GLP-1](https://elonmuscular.com/protocol-glp1-muscle/). Found **14.9% of body weight off.** Over 68 weeks, semaglutide 2.4 mg took off 14.9% of body weight, 34 lb (15.3 kg) on average, against 2.4% on a dummy shot. Why It copies GLP-1, the meal-is-done hormone, made to last a week. Hunger drops and food thoughts go quiet, so the deficit is easier to hold. Watch The label's boxed warning: thyroid C-cell tumors in rodents. So never with a personal or family history of medullary thyroid cancer or MEN 2\. A lump in the neck, trouble swallowing, breathlessness or a hoarse voice that lasts: tell the doctor. Never after a serious allergic reaction to it. The dose steps up every 4 weeks. If a step is not tolerated, the next is delayed 4 weeks. Severe gut side effects, and not with severe gastroparesis. Pancreatitis: severe belly pain that will not go, sometimes into the back, means stop it and get seen. Gallstones and gallbladder inflammation. Low blood sugar with insulin or a sulfonylurea. Kidney injury when sickness or diarrhea dries you out. Anaphylaxis and swelling of the face or throat. Diabetic eye disease can get worse. The resting heart rate rises, so it is checked at regular intervals. A racing heart at rest: tell the doctor. Food can stay in the stomach under anesthesia or deep sedation: tell the team before any procedure. The tablet form raised levothyroxine levels 33%. Never share a pen. A sudden loss of vision, usually in one eye: get urgent help. Muscle goes with the fat unless you keep lifting and keep the protein high. Hold both the whole time. #### The study The mean change in body weight from baseline to week 68 was -14.9% in the semaglutide group as compared with -2.4% with placebo, for an estimated treatment difference of -12.4 percentage points (95% confidence interval \[CI\], -13.4 to -11.5; P<0.001). [PMID 33567185](https://pubmed.ncbi.nlm.nih.gov/33567185/?ref=elonmuscular.com) · Once-Weekly Semaglutide in Adults with Overweight or Obesity. · The New England journal of medicine, 2021 The sentence around it …Results The mean change in body weight from baseline to week 68 was -14.9% in the semaglutide group as compared with -2.4% with placebo, for an estimated treatment difference of -12.4 percentage points (95% confidence interval \[CI\], -13.4 to -11.5; P<0.001). The change in body weight from baseline to week 68 was -15.3 kg in the semaglutide group as compared with -2.6 kg in the placebo group (estimated treatment difference, -12.7 kg; 95% CI, -13.7 to -11.7). The sentence around it The change in body weight from baseline to week 68 was -15.3 kg in the semaglutide group as compared with -2.6 kg in the placebo group (estimated treatment difference, -12.7 kg; 95% CI, -13.7 to -11.7). [The deep dive on this](https://elonmuscular.com/semaglutide/) 34OrforglipronA daily GLP-1 tablet, stepped up every 30 daysModerate evidence ### Orforglipron: the daily GLP-1 tablet, with a doctor For: Rather take a pill A daily tablet that works like the weekly shots. About a ninth of body weight off on the top dose. #### What to do 1. For a lot of fat to lose, on a prescription only, from a registered pharmacy. 2. Start at 0.8 mg a day; step up every 30 days at the fastest. 3. Keep lifting and keep the protein high. 4. Tell the pharmacist every other medicine you take. How much 0.8 mg to 17.2 mg a day When Once a day How long Long term Standard practice Starts at 0.8 mg once daily; after at least 30 days, 2.5 mg, then 5.5 mg, then 9, 14.5 or 17.2 mg by response. 17.2 mg is the maximum. The trial doses are shown on the label as 5.5, 9 and 17.2 mg. What happened in the studies 11.2%off on the top dose At 72 weeks, weight fell 11.2% on the top dose of the daily tablet, against 2.1% on a dummy pill. ¹ The New England journal of medicine, 2025\. The study is under The science, below. Watch out Boxed warning: thyroid tumors seen in rodents with this drug class. Never with a personal or family history of medullary thyroid cancer or MEN 2, or after a serious allergy to it. A neck lump or hoarse voice that lasts: tell the doctor. The dose climbs every 30 days at the fastest; sickness peaks during the climb. Severe belly pain that will not go can be pancreatitis: stop and get seen. Kidney injury if sickness dries you out. Gallstones. Low sugar with diabetes pills. Allergic swelling of the face or throat: emergency. Tell anyone sedating you. Some antibiotics, antifungals, HIV drugs and simvastatin interact: tell the pharmacist everything. Never with another GLP-1 drug. Keep lifting and keep the protein up, or muscle goes with the fat. Diabetic eye disease can worsen. The science In detail For a lot of fat to lose, if you would rather take a pill: it is prescribed for obesity, or overweight with a weight-related condition. A daily tablet, on a prescription only, from a registered pharmacy. It starts at 0.8 mg a day, then 2.5 mg, then 5.5 mg, each step after at least 30 days. It can go on to 9, 14.5 or 17.2 mg, the maximum. Swallow it whole, with or without food. Keep lifting and keep the protein high. Prescription. The full plan is on [Weight loss injections and surgery](https://elonmuscular.com/protocol-weight-medicine/); keeping the muscle is [Muscle loss on GLP-1](https://elonmuscular.com/protocol-glp1-muscle/). Found **11.2% of body weight off.** At 72 weeks, weight fell 11.2% on the top dose, 8.4% on the middle dose and 7.5% on the lowest, against 2.1% on a dummy pill. Waist, blood pressure and blood fats improved too. Why A small molecule, not a protein, that switches on the GLP-1 receptor like the shots do. So it works as a pill, with no fasting routine and no fridge. Watch The label's boxed warning: drugs of this class caused thyroid C-cell tumors in rodents. Orforglipron did not cause them in rodents. Even so, never with a personal or family history of medullary thyroid cancer or MEN 2\. A lump in the neck, trouble swallowing, breathlessness or a hoarse voice that lasts: tell the doctor. Never after a serious allergic reaction to it. The dose steps up no sooner than every 30 days. Sickness, vomiting and diarrhea can be severe, and it is not for severe gastroparesis. Pancreatitis: severe belly pain that will not go, sometimes into the back, means stop it and get seen. Kidney injury when sickness dries you out. Gallstones and gallbladder inflammation. Low blood sugar with insulin or a sulfonylurea. Anaphylaxis and swelling of the face or throat. Diabetic eye disease can get worse. Food can stay in the stomach under anesthesia or deep sedation: tell the team before any procedure. Strong CYP3A4 blockers cap it at 9 mg. These include some antibiotics, antifungals and HIV drugs. Strong inducers such as rifampin are avoided. Simvastatin no higher than 20 mg. It slows how other pills absorb. Never with another GLP-1 drug. Missed 7 or more days: restart lower. Muscle goes with the fat unless you keep lifting and keep the protein high. Hold both the whole time. #### The study The mean change in body weight from baseline to week 72 was -7.5% (95% confidence interval \[CI\], -8.2 to -6.8) with 6 mg of orforglipron, -8.4% (95% CI, -9.1 to -7.7) with 12 mg of orforglipron, and -11.2% (95% CI, -12.0 to -10.4) with 36 mg of orforglipron, as compared with -2.1% (95% CI, -2.8 to -1.4) with placebo (P<0.001 for all comparisons with placebo). [PMID 40960239](https://pubmed.ncbi.nlm.nih.gov/40960239/?ref=elonmuscular.com) · Orforglipron, an Oral Small-Molecule GLP-1 Receptor Agonist for Obesity Treatment. · The New England journal of medicine, 2025 The sentence around it The mean change in body weight from baseline to week 72 was -7.5% (95% confidence interval \[CI\], -8.2 to -6.8) with 6 mg of orforglipron, -8.4% (95% CI, -9.1 to -7.7) with 12 mg of orforglipron, and -11.2% (95% CI, -12.0 to -10.4) with 36 mg of orforglipron, as compared with -2.1% (95% CI, -2.8 to -1.4) with placebo (P<0.001 for all comparisons with placebo). Waist circumference, systolic blood pressure, triglyceride levels, and non-HDL cholesterol levels significantly improved with orforglipron treatment as compared with placebo. The sentence around it Waist circumference, systolic blood pressure, triglyceride levels, and non-HDL cholesterol levels significantly improved with orforglipron treatment as compared with placebo. 35Liraglutide 3 mg: the daily shotA daily shot, stepped up weekly to 3 mgModerate evidence ### Liraglutide 3 mg: the daily shot For: A lot of fat to lose A daily GLP-1 shot, the older option. It works, with less loss than the weekly shots. #### What to do 1. Start at 0.6 mg a day; step up weekly to 3 mg. 2. Judge at 16 weeks: under 4% lost, stop. 3. Missed more than 3 days: restart low. How much 0.6 mg to 3 mg a day When Once a day How long Judge at 16 weeks Standard practice Starts at 0.6 mg a day for a week, rising weekly to 3 mg. Judge at 16 weeks: under 4% lost, stop. More than 3 days missed: restart at 0.6 mg. What happened in the studies 15lb(6.8 kg) more kept off After a diet, a year on liraglutide kept 15 lb (6.8 kg) more off than a dummy shot. ¹ The New England journal of medicine, 2015\. The study is under The science, below. Watch out Boxed warning: thyroid tumors in rodents. Never with a personal or family history of medullary thyroid cancer or MEN 2\. Severe belly pain that will not go can be pancreatitis: stop and get seen. Gallstones, low sugar with diabetes pills, a faster pulse, kidney injury if sickness dries you out. Allergic swelling of the face or throat: emergency. The dose climbs weekly. Tell anyone sedating you. Never with another GLP-1 drug. Keep lifting and keep the protein up, or muscle goes with the fat. A neck lump, trouble swallowing or a hoarse voice that lasts: tell the doctor. Never after a serious allergy to it. The science In detail For a lot of fat to lose, not the last few kilos: it is prescribed for obesity, or overweight with a weight-related condition. A daily injection, on a prescription. It starts at 0.6 mg a day and rises weekly to 3 mg. Judge at 16 weeks: under 4% lost, stop. Prescription. The full plan: [Weight loss injections and surgery](https://elonmuscular.com/protocol-weight-medicine/). Found Over 56 weeks, liraglutide 3 mg with diet and exercise went with lower weight and better metabolic control. After a diet, a year on it kept 15 lb (6.8 kg) more off than a dummy shot. Why The first GLP-1 shot licensed for weight. It lasts a day rather than a week, so it is a daily shot. A fallback when the weekly shots do not suit you. Watch The label's boxed warning: thyroid C-cell tumors in rats and mice, so never with a personal or family history of medullary thyroid cancer or MEN 2\. A lump in the neck, trouble swallowing, breathlessness or a hoarse voice that lasts: tell the doctor. Pancreatitis: severe belly pain that will not go, sometimes into the back, means stop it and get seen. Gallstones and gallbladder inflammation. Low blood sugar with insulin or a sulfonylurea. The resting heart rate rises and is checked: a racing heart at rest, tell the doctor. Kidney injury when sickness dries you out. Severe gut side effects: the dose climbs weekly, and a step can wait a week. Anaphylaxis and swelling of the face or throat. Food can stay in the stomach under anesthesia or deep sedation: tell the team. Never with another GLP-1 drug. More than 3 days missed: restart at 0.6 mg. Muscle goes with the fat unless you keep lifting and keep the protein high: hold both the whole time. #### The studies In this study, 3.0 mg of liraglutide, as an adjunct to diet and exercise, was associated with reduced body weight and improved metabolic control. [PMID 26132939](https://pubmed.ncbi.nlm.nih.gov/26132939/?ref=elonmuscular.com) · A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management. · The New England journal of medicine, 2015 The sentence around it …Conclusions In this study, 3.0 mg of liraglutide, as an adjunct to diet and exercise, was associated with reduced body weight and improved metabolic control. in the liraglutide group, -6.8 kg (95% CI, -10.4 to -3.1; P<0.001) [PMID 33951361](https://pubmed.ncbi.nlm.nih.gov/33951361/?ref=elonmuscular.com) · Healthy Weight Loss Maintenance with Exercise, Liraglutide, or Both Combined. · The New England journal of medicine, 2021 The sentence around it …At 1 year, all the active-treatment strategies led to greater weight loss than placebo: difference in the exercise group, -4.1 kg (95% confidence interval \[CI\], -7.8 to -0.4; P = 0.03); in the liraglutide group, -6.8 kg (95% CI, -10.4 to -3.1; P<0.001); and in the combination group, -9.5 kg (95% CI, -13.1 to -5.9; P<0.001).… [The deep dive on this](https://elonmuscular.com/liraglutide/) 36Naltrexone-bupropionA craving tablet, built up over 4 weeksModerate evidence ### Naltrexone-bupropion: the craving tablet For: Cravings break the cut A tablet that quiets cravings. Modest loss, with mood and seizure warnings to respect. #### What to do 1. Build up over 4 weeks to two tablets twice a day. 2. Never two tablets at once, never with a fatty meal. 3. Under 5% lost at 12 weeks: stop. How much Up to 4 tablets a day When Morning and evening How long Judge at 12 weeks Standard practice Full dose of 32 mg naltrexone and 360 mg bupropion a day from week 4\. Judge at 12 weeks on it: under 5% lost, stop. 14 days between it and an MAOI. The boxed warning covers ages 18 to 24. What happened in the studies 6.1%off on the full dose Over 56 weeks, weight fell 6.1% on the full dose against 1.3% on a dummy pill. ¹ Lancet (London, England), 2010\. The study is under The science, below. Watch out Boxed warning: suicidal thoughts, raised up to age 24\. Never with past seizures, uncontrolled blood pressure, bulimia or anorexia, other bupropion, opioids, or within 14 days of an MAOI. Never while quitting alcohol or sedatives suddenly. Never two tablets at once or with a fatty meal. It raises blood pressure and pulse, and blocks opioid painkillers. Yellow skin or dark pee: stop and get seen. Mania, sudden eye pain from glaucoma, allergic rashes, and low sugar with diabetes pills. Little or no alcohol. The science In detail For a lot of fat to lose, not the last few kilos: it is prescribed for obesity, or overweight with a weight-related condition. It suits a cut lost to cravings. A tablet on a prescription. Week 1: one in the morning. Week 2: one morning, one evening. Week 3: two morning, one evening. Week 4 on: two and two, 32 mg naltrexone and 360 mg bupropion a day. Never with a high-fat meal. Under 5% lost at 12 weeks on the full dose: stop. Prescription. The full plan: [Weight loss injections and surgery](https://elonmuscular.com/protocol-weight-medicine/). Found **6.1% off, against 1.3%.** Over 56 weeks, weight fell 6.1% on the full dose against 1.3% on a dummy pill. 48% lost 5% or more, against 16%. Why Bupropion lifts the brain’s fullness signal; naltrexone stops that signal switching itself off. The pair targets cravings and food reward more than stomach fullness. Watch The label's boxed warning: suicidal thoughts and behavior, a risk raised up to age 24\. Never with seizures in your past, uncontrolled high blood pressure, bulimia or anorexia, or another bupropion product. Never with regular opioids, opioid withdrawal, or within 14 days of an MAOI. Never while stopping alcohol, benzodiazepines, barbiturates or seizure medicines suddenly. Seizures: never more than two tablets at once, and never with a high-fat meal. Blood pressure and pulse can rise, most in the first three months, so both are checked. It blocks opioid painkillers, and taking large amounts to override the block can kill. Liver injury: yellow skin, dark pee or belly pain, stop and get seen. Mania, angle-closure glaucoma, rashes and allergic reactions. Low blood sugar with diabetes medicines. Keep alcohol to a minimum, or none. #### The study Mean change in bodyweight was -1.3% (SE 0.3) in the placebo group, -6.1% (0.3) in the naltrexone 32 mg plus bupropion group (p<0.0001 vs placebo) [PMID 20673995](https://pubmed.ncbi.nlm.nih.gov/20673995/?ref=elonmuscular.com) · Effect of naltrexone plus bupropion on weight loss in overweight and obese adults (COR-I): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial. · Lancet (London, England), 2010 The sentence around it Mean change in bodyweight was -1.3% (SE 0.3) in the placebo group, -6.1% (0.3) in the naltrexone 32 mg plus bupropion group (p<0.0001 vs placebo) and -5.0% (0.3) in the naltrexone 16 mg plus bupropion group (p<0.0001 vs placebo).… 37Phentermine-topiramateA morning capsule, stepped up by the 12-week resultModerate evidence ### Phentermine-topiramate: the US once-daily capsule For: A lot of fat to lose, US only A morning capsule of two old drugs at low doses. It takes off close to a tenth of body weight. #### What to do 1. US only: a prescription and a controlled drug. 2. Start low for 14 days, then the usual dose. 3. Judge at 12 weeks with the doctor. 4. Never stop the top dose suddenly. How much One capsule a day When Each morning How long Judge at 12 weeks Standard practice Starts at 3.75/23 mg daily for 14 days, then 7.5/46 mg. At 12 weeks, under 3% lost: 11.25/69 mg for 14 days, then 15/92 mg. Under 5% at 12 weeks on 15/92: stop, every other day for a week. What happened in the studies 9.2%off at 28 weeks At 28 weeks, the combination took off 8.5% to 9.2% of body weight, against 1.7% on a dummy pill. ¹ Obesity (Silver Spring, Md.), 2013\. The study is under The science, below. Watch out Never in pregnancy, or with glaucoma, an overactive thyroid, or within 14 days of an MAOI. Sudden blurred vision or eye pain: stop and get seen now. It can slow thinking and cause kidney stones and acid in the blood, so bloods are checked. Mood swings, poor sleep, less sweating and overheating, low potassium, and a faster pulse. A new rash: stop it. Stop the top dose slowly, never suddenly. Go easy on alcohol. A controlled drug. The science In detail For a lot of fat to lose, not the last few kilos: it is prescribed for obesity, or overweight with a weight-related condition. A capsule each morning, US only: not licensed in the UK. It starts at 3.75/23 mg for 14 days, then 7.5/46 mg. Under 3% lost at 12 weeks: step to 11.25/69, then 15/92\. Under 5% lost at 12 weeks on the top dose: stop, tapering it. The full plan: [Weight loss injections and surgery](https://elonmuscular.com/protocol-weight-medicine/). Found At 28 weeks, it took off 8.5% on 7.5/46 mg and 9.2% on 15/92 mg, against 1.7% on a dummy pill. It beat either drug alone. Why Phentermine is a stimulant that blunts appetite; topiramate adds fullness and cuts food reward. Low doses of both together beat a higher dose of either. Watch It harms an unborn baby, so never in pregnancy. Never with glaucoma, an overactive thyroid, or within 14 days of an MAOI. Sudden blurred vision or eye pain: stop it and get seen now, it can be acute glaucoma. Mood swings, anxiety and poor sleep. Slower thinking, poor memory and word-finding trouble: take care driving at the start. Acid build-up in the blood and a fall in kidney function: salts, creatinine and potassium are checked before and during. Kidney stones: drink plenty. Less sweating and overheating, most in hot weather while active. Rare severe rashes and whole-body allergic reactions: stop at the first rash. The top dose is stopped slowly, every other day for at least a week, or a seizure can follow. Alcohol adds dizziness and drowsiness. The resting heart rate rises. A controlled drug in the US. Daily dose**7.5/46 mg** *8.5% of weight off at 28 weeks* 7.5/46 mg15/92 mg PHEN/TPM ER 7.5/46 (-8.5%) [PMID 24136928](https://pubmed.ncbi.nlm.nih.gov/24136928/?ref=elonmuscular.com) #### The study At week 28, PHEN/TPM ER 7.5/46 (-8.5%) and 15/92 (-9.2%) achieved greater percentage WL versus placebo (-1.7%; P < 0.0001) and their respective monotherapies (P < 0.05). [PMID 24136928](https://pubmed.ncbi.nlm.nih.gov/24136928/?ref=elonmuscular.com) · Evaluation of phentermine and topiramate versus phentermine/topiramate extended-release in obese adults. · Obesity (Silver Spring, Md.), 2013 The sentence around it …Results At week 28, PHEN/TPM ER 7.5/46 (-8.5%) and 15/92 (-9.2%) achieved greater percentage WL versus placebo (-1.7%; P < 0.0001) and their respective monotherapies (P < 0.05). 38PhentermineA short-term appetite tablet, a few weeksEarly evidence ### Phentermine: a few weeks, US only For: US, a few weeks only An older stimulant tablet for a few weeks of lower appetite. US only. #### What to do 1. US only, a controlled drug. 2. 37.5 mg each morning, or 8 mg before meals. 3. Never late in the evening. 4. A few weeks, then stop. How much 37.5 mg once, or 8 mg up to 3 times When Morning or before meals How long A few weeks Standard practice A short-term add-on, a few weeks, to diet, exercise and behavior change. One 8 mg tablet three times a day half an hour before meals, or one 37.5 mg tablet each morning; avoid late evening doses. A Schedule IV controlled drug. What happened in the studies 46.2%lost 5% or more In a 28-week trial, 46.2% lost 5% or more on phentermine alone, against 15.5% on a dummy pill. ¹ Obesity (Silver Spring, Md.), 2013\. The study is under The science, below. Watch out A few weeks only. Never with heart disease, high blood pressure, an overactive thyroid, glaucoma, a drug problem, or within 14 days of an MAOI. Rare lung and heart valve damage: new breathlessness, chest pain or fainting, stop and get seen. It raises blood pressure and can impair driving. It can be misused: when it stops working, stop it. No alcohol, and no other weight drugs, with it. A controlled drug. The science In detail For a lot of fat to lose, not the last few kilos: it is prescribed for obesity, or overweight with a weight-related condition. A short-term appetite tablet, US only, for a few weeks alongside diet and exercise. Two label strengths: one 37.5 mg tablet each morning, or one 8 mg tablet up to three times a day, half an hour before meals. Never late in the evening. A controlled drug; not licensed in the UK. The full plan: [Weight loss injections and surgery](https://elonmuscular.com/protocol-weight-medicine/). Found In a 28-week trial, 46.2% lost 5% or more on phentermine 15 mg alone, the trial's dose, not a label dose, against 15.5% on a dummy pill. Why A stimulant related to amphetamine that turns appetite down for a while. The effect fades, which is why it is labeled for weeks, not months. Watch Short-term only: a few weeks. Never with heart disease, a stroke, an irregular heartbeat, heart failure or uncontrolled blood pressure. Never with an overactive thyroid, glaucoma, agitation, a history of drug misuse, or within 14 days of an MAOI. Rare, often fatal lung blood-pressure disease and heart valve damage were reported, mostly with fenfluramine: new breathlessness, chest pain or fainting, stop and get seen. It raises blood pressure. It is related to amphetamine, can be misused and can cause dependence: if the effect fades, stop rather than take more. It can impair driving. Alcohol can react with it. Never with other weight-loss drugs. A controlled drug. #### The study The percentage of subjects achieving ≥5% WL was 15.5% for placebo, 43.3% for phentermine 7.5, 46.2% for phentermine 15, 39.2% for topiramate ER 46, 48.6% for topiramate ER 92, 62.1% for PHEN/TPM ER 7.5/46, and 66.0% for PHEN/TPM ER 15/92. [PMID 24136928](https://pubmed.ncbi.nlm.nih.gov/24136928/?ref=elonmuscular.com) · Evaluation of phentermine and topiramate versus phentermine/topiramate extended-release in obese adults. · Obesity (Silver Spring, Md.), 2013 The sentence around it The percentage of subjects achieving ≥5% WL was 15.5% for placebo, 43.3% for phentermine 7.5, 46.2% for phentermine 15, 39.2% for topiramate ER 46, 48.6% for topiramate ER 92, 62.1% for PHEN/TPM ER 7.5/46, and 66.0% for PHEN/TPM ER 15/92. 39Gastric balloon or endoscopic sleeveA balloon or stitched sleeve, done through the mouthModerate evidence ### Balloon or endoscopic sleeve: through the mouth, no cuts For: Between drugs and surgery A balloon or a stitched stomach, done through the mouth with no cuts. A middle step before surgery. #### What to do 1. Ask a specialist weight service about both. 2. Plan the diet and follow-up that go with them. 3. Severe pain or vomiting blood after: 911. How much One procedure When With a specialist How long Months, then follow-up Standard practice A balloon goes in after a camera check, swallowed or placed, then filled. An endoscopic sleeve folds and stitches the stomach through a tube, up to 80% smaller, with no cuts and no stomach removed. What happened in the studies 13.6%off with the endoscopic sleeve At 52 weeks, the endoscopic sleeve took off 13.6% of body weight, against 0.8% with lifestyle alone. ¹ Lancet (London, England), 2022\. The study is under The science, below. Watch out Severe belly pain or vomiting blood after: 911. The science In detail For a lot of fat to lose, between the medicines and surgery. Two procedures done through the mouth with a camera, no cuts. A balloon is placed in the stomach and filled with salt water, then taken out later. An endoscopic sleeve stitches the stomach into folds, up to 80% smaller, and may be reversible. Ask a specialist weight service or an endoscopy team. The full plan: [Weight loss injections and surgery](https://elonmuscular.com/protocol-weight-medicine/). Found **13.6% off at 52 weeks.** At 52 weeks, the endoscopic sleeve took off 13.6% of body weight, against 0.8% with lifestyle alone. A review of 15 trials: the balloon beat standard care for weight loss at 6, 9 and 12 months. Why Both make the stomach hold less and empty slower, so you feel full sooner. They sit between the medicines and surgery: less loss than surgery, less recovery. Watch Sickness, cramps and vomiting in the first days, most with the balloon. Rare serious harms: bleeding, a tear or a leak, and a balloon that deflates and moves. Severe belly pain, vomiting blood or black stools: 911. #### The studies Mean percentage of total bodyweight loss was 13·6% (8·0) for the ESG group and 0·8% (5·0) for the control group (p<0·0001) [PMID 35908555](https://pubmed.ncbi.nlm.nih.gov/35908555/?ref=elonmuscular.com) · Endoscopic sleeve gastroplasty for treatment of class 1 and 2 obesity (MERIT): a prospective, multicentre, randomised trial. · Lancet (London, England), 2022 The sentence around it Mean percentage of total bodyweight loss was 13·6% (8·0) for the ESG group and 0·8% (5·0) for the control group (p<0·0001), and 59 (77%) of 77 participants in the ESG group reached 25% or more of EWL at 52 weeks compared with 13 (12%) of 110 in the control group (p<0·0001).… Compared with SMT, IGB significantly improved the percentage of excess weight loss at 6 months (MD 16.80; 95% CI 9.22-24.38), 9 months (MD 14.36; 95% CI 7.67-21.04), and 12 months (MD 13.10; 95% CI 10.43-15.77). [PMID 40932823](https://pubmed.ncbi.nlm.nih.gov/40932823/?ref=elonmuscular.com) · Intragastric balloon for obesity treatment: Systematic review and meta-analysis of randomized controlled trials. · Endoscopy international open, 2025 The sentence around it Compared with SMT, IGB significantly improved the percentage of excess weight loss at 6 months (MD 16.80; 95% CI 9.22-24.38), 9 months (MD 14.36; 95% CI 7.67-21.04), and 12 months (MD 13.10; 95% CI 10.43-15.77). 40Metabolic and bariatric surgeryThe biggest, longest loss: ask for the referralModerate evidence ### Weight-loss surgery: ask for the referral For: BMI 40, or 35 with a condition The biggest and longest-lasting loss. At a BMI of 40, or 35 with a condition, ask for a referral. #### What to do 1. BMI 40, or 35 with diabetes, apnea or high blood pressure? 2. Ask your doctor for a specialist weight service referral. 3. The team assesses your body, food habits and mind first. How much One referral When At the qualifying BMI How long Lifelong follow-up Standard practice A faster assessment at 35 with type 2 diabetes from the past 10 years. Internationally, surgery is recommended from a BMI of 35. What happened in the studies 57lb(26 kg) more off Across 11 trials, surgery took off 57 lb (26 kg) more than treatment without surgery. ¹ BMJ (Clinical research ed.), 2013\. The study is under The science, below. Watch out Blood clots, a leak where the stomach is joined, wound infection, a narrowed or blocked gut, gallstones and loose skin are the main risks. Vitamins, minerals and yearly checks for life. Chest pain, or a painful swollen leg, after surgery: 911. The science In detail For a lot of fat to lose, far past the belly: this is for a BMI of 40, or 35 with a condition. A referral, not a prescription. At a BMI of 40, or 35 with a condition such as diabetes or sleep apnea, ask your doctor for a referral to a specialist weight service. The usual operations are the sleeve, which removes about 80% of the stomach, and the gastric bypass. The full plan: [Weight loss injections and surgery](https://elonmuscular.com/protocol-weight-medicine/). Found **57 lb (26 kg) more off than without surgery.** In a review of 11 trials, surgery took off 57 lb (26 kg) more than treatment without surgery. In a long study, weight losses held at 25% after bypass at 10 years, and deaths were lower than in matched controls. Why Surgery shrinks the stomach and rewires the gut hormones, so hunger drops for years. It is the largest and longest-lasting loss available, and it comes with lifelong follow-up. Watch Blood clots, a leak where the stomach is joined, infection, a narrowed gut, gallstones and loose skin. Lifelong vitamins and yearly checks. The details: the next card. #### The studies Individuals allocated to bariatric surgery lost more body weight (mean difference -26 kg (95% confidence interval -31 to -21)) compared with non-surgical treatment [PMID 24149519](https://pubmed.ncbi.nlm.nih.gov/24149519/?ref=elonmuscular.com) · Bariatric surgery versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomised controlled trials. · BMJ (Clinical research ed.), 2013 The sentence around it Individuals allocated to bariatric surgery lost more body weight (mean difference -26 kg (95% confidence interval -31 to -21)) compared with non-surgical treatment After 10 years, the weight losses from baseline were stabilized at 25%, 16%, and 14%, respectively. [PMID 17715408](https://pubmed.ncbi.nlm.nih.gov/17715408/?ref=elonmuscular.com) · Effects of bariatric surgery on mortality in Swedish obese subjects. · The New England journal of medicine, 2007 The sentence around it After 10 years, the weight losses from baseline were stabilized at 25%, 16%, and 14%, respectively. 41After surgery: the risks and the checksKnow the risks; vitamins and yearly checks for lifeModerate evidence ### Surgery: the risks and the lifelong checks For: Anyone considering surgery Surgery is safe for most, and it is for life: vitamins, checks and eating habits change for good. #### What to do 1. Ask the team your personal risk before you sign. 2. Small bites, chew well, no drinks with meals. 3. Vitamins and yearly checks for life. How much Daily supplements When For life How long For life Standard practice The main risks are blood clots, a stomach leak, wound infection, a blocked gut, gallstones and excess skin. Cut food small, chew well and do not drink during meals. Lifelong nutrition checks and supplements. What happened in the studies 0.3%died within 30 days In a large safety study, 0.3% died within 30 days, and 4.3% had a major complication. ¹ The New England journal of medicine, 2009\. The study is under The science, below. Watch out Chest pain or a swollen, painful leg after surgery: 911. The science In detail Before any operation, know this. Know the risks before you sign. After surgery: cut food small, chew well and do not drink with meals. Take the vitamins and minerals the team sets, for life. Go to every yearly review. Drink far less alcohol than before. The full plan: [Weight loss injections and surgery](https://elonmuscular.com/protocol-weight-medicine/). Found In a large safety study, 0.3% died within 30 days of a bypass or band, and 4.3% had a major complication. A bypass lost more excess weight than a sleeve at 5 years, 62.7% against 55.5%, with more complications. Why The operation changes how you absorb food for good. Iron, vitamin and protein shortfalls build quietly, so the checks and the supplements are part of the treatment. Watch Trouble breathing or chest pain with a painful, swollen leg, severe belly pain, or vomiting blood: 911 now. A fast heartbeat, fever, belly pain or repeated vomiting after surgery: urgent care or your doctor today. #### The studies The 30-day rate of death among patients who underwent a Roux-en-Y gastric bypass or laparoscopic adjustable gastric banding was 0.3%; a total of 4.3% of patients had at least one major adverse outcome. [PMID 19641201](https://pubmed.ncbi.nlm.nih.gov/19641201/?ref=elonmuscular.com) · Perioperative safety in the longitudinal assessment of bariatric surgery. · The New England journal of medicine, 2009 The sentence around it The 30-day rate of death among patients who underwent a Roux-en-Y gastric bypass or laparoscopic adjustable gastric banding was 0.3%; a total of 4.3% of patients had at least one major adverse outcome. Model-based mean estimate of %EBMIL was 7.0 (95 per cent c.i. 3.5 to 10.5) percentage points better after LRYGB than after LSG (62.7 versus 55.5 per cent respectively; P < 0.001). [PMID 33640917](https://pubmed.ncbi.nlm.nih.gov/33640917/?ref=elonmuscular.com) · Laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy: 5-year outcomes of merged data from two randomized clinical trials (SLEEVEPASS and SM-BOSS). · The British journal of surgery, 2021 The sentence around it Model-based mean estimate of %EBMIL was 7.0 (95 per cent c.i. 3.5 to 10.5) percentage points better after LRYGB than after LSG (62.7 versus 55.5 per cent respectively; P < 0.001). 42Testosterone therapy, if a doctor confirms it is lowOnly when two morning tests and the symptoms agreeStrong evidence ### Testosterone therapy, if a doctor confirms it is low For: Confirmed low T Testosterone from a doctor, only when tests confirm it is low. #### What to do 1. Only after two low morning tests and the symptoms. 2. Freeze sperm first if you want children. 3. Your doctor sets the dose and checks the prostate. 4. Leg pain and swelling, or sudden breathlessness: stop and get seen. How much Doctor-set When As prescribed How long Ongoing Standard practice On the gel, blood pressure is measured periodically, and children keep off the skin where it went on. What happened in the studies Fat down, lean mass up In 59 trials, testosterone therapy lowered fat and raised lean mass. ¹ European journal of endocrinology, 2016\. The study is under The science, below. Watch out It can suppress sperm production. Blood pressure, red blood cells and the risk of blood clots can rise. It is ruled out by breast or prostate cancer, and the prostate is checked. It can worsen sleep apnea, cause swelling and grow breast tissue. It is not established for low testosterone that comes with age. Boxed warning on the gel: children and women must not touch the skin where it went on; cover it and wash your hands. It can be abused and can cause dependence. The science In detail Only for testosterone confirmed low: the symptoms, plus low levels on repeat morning tests. A doctor prescribes it and sets the dose on your blood tests. Keep the lifting and the deficit going. If you want children, that talk comes first. The full detail: [TRT](https://elonmuscular.com/protocol-testosterone-trt/). UK and US: prescription only. Found **59 trials; fat down, lean mass up.** 59 trials: testosterone therapy lowered fat and raised lean mass, and fasting sugar and insulin resistance fell with them. Why Low testosterone makes fat easier to gain and muscle harder to keep. Put back to normal, it shifts the body toward muscle and away from fat. Watch The label: sperm production can be suppressed. Red cell count and blood pressure can rise, and blood clots in the legs and lungs have been reported. The prostate is checked before and during treatment, and breast or prostate cancer rules it out. It can worsen sleep apnea, cause fluid retention and grow breast tissue. Its safety and benefit in age-related low testosterone are not established. On the gel, children and women must not touch the skin where it went on. It has been abused at high doses, with serious heart and mental-health harms, and the label lists dependence. #### The study TS was associated with a significant reduction in fat and with an increase in lean mass as well as with a reduction of fasting glycaemia and insulin resistance. [PMID 26537862](https://pubmed.ncbi.nlm.nih.gov/26537862/?ref=elonmuscular.com) · THERAPY OF ENDOCRINE DISEASE: Testosterone supplementation and body composition: results from a meta-analysis study. · European journal of endocrinology, 2016 The sentence around it TS was associated with a significant reduction in fat and with an increase in lean mass as well as with a reduction of fasting glycaemia and insulin resistance. [The deep dive on this](https://elonmuscular.com/male-hrt/) ## How you'll know it's working Track The weekly average weight, falling 0.5 to 1% a week, read with the tape and the photos How to track Weigh every morning and average the week. Tape the waist and take photos once a week. Log every set. When to judge The weekly average should fall from week one. The waist moves every week or two. Plan the cut in a 12-week block and judge the whole picture at 12. New Heroes The full library. Elon answers every weekday. [Join New Heroes.](https://elonmuscular.com/join/) Cancel anytime. ## Why this happens You want to see your abs. Maybe for summer, maybe because you have trained for years and they are still hiding. The muscle is there already. What covers it is a layer of fat, and you want it off without losing the muscle you built. ### The cover Everyone has abs. What hides them is the fat on top, and it comes off the whole body at once, belly included, as the weekly average falls. You cannot pick where it goes first. Stronger, thicker abs show through a little more of it. ### The gap Fat comes off through a steady deficit: 0.5 to 1% of body weight a week, slower as you get leaner. Walking keeps the everyday burn from sliding, and seven to nine hours of sleep decides how much of the loss is fat. ### The keep Heavy lifting and plenty of protein tell the body to keep the muscle while food is short. The muscle kept is what makes the abs worth seeing. Too little fuel for too long, and hormones and strength fall: that is the signal to stop. 0.5 to 1% a weekAbout 8,500 steps7 to 9 hours asleepA crash dietWater cutsFat off, everywhereHeavy lifting, twice aweekProtein 1 to 1.4 g/lb(2.2 to 3.0 g/kg)Creatine 3 to 5 gCutting the weightsMuscle keptLoaded ab work twice aweekToo little fuelAbs that show throughVisibleabs, themuscle keptVisibleabs, themuscle keptVisibleabs, themuscle keptVisibleabs, themuscle keptThe gapThe keepThe shape0.5 to 1% a weekAbout 8,500 steps7 to 9 hours asleepA crash dietWater cutsFat off, everywhereHeavy lifting, twice a weekProtein 1 to 1.4 g/lb (2.2 to 3.0g/kg)Creatine 3 to 5 gCutting the weightsMuscle keptLoaded ab work twice a weekToo little fuelAbs that show throughVisible abs, the musclekeptVisible abs, the musclekeptVisible abs, the musclekeptVisible abs, the musclekeptThe gapThe keepThe shape **Figure 2.** How the moves lead to visible abs, the muscle kept. The dotted orange boxes are the things to cut back. ## Week by week Why this order Take the first measurements and check the stop signs. Then the lifting, the pace, the protein, the steps and the sleep go in together. After that, one addition at a time, so you know which one is working. 0246810121416Weeks from the startPhotos, tape, weigh-ins;the rule-outsWeekly average, tape andphotosHeavy lifting and ab work0.5 to 1% a week, protein,steps, sleepCreatine, 3 to 5 gThe reviewA diet break or refeeds, ifthe cut runs longAbs showing: ease food backupReview, week 120246810121416Weeks from the startPhotos, tape, weigh-ins; the rule-outsWeekly average, tape and photosHeavy lifting and ab work0.5 to 1% a week, protein, steps, sleepCreatine, 3 to 5 gThe reviewA diet break or refeeds, if the cut runslongAbs showing: ease food back upReview, week 12 **Figure 3.** The plan by week: navy bars keep going, orange bars are the moves you add, white bars are checks and decisions. The starburst marks the review at week 12. Swipe sideways to see the whole table | When | Add | Why then | | ------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | -------------------------------------------------------------------------------------------------------------------------------------------- | | Week 0 | Photos, tape, and a week of morning weigh-ins. Snoring and tired all day, a medicine that adds weight, or past steroid use: your doctor first. | The first numbers are the baseline every week after is judged against. | | Weeks 0 to 1 | Three or four lifting days, heavy, every big muscle twice, about ten hard sets each. Loaded ab work twice a week. Protein at 1 g per pound (2.2 g per kilo) or more. Eat enough less to lose 0.5 to 1% a week. Walk toward 8,500 steps. Seven to nine hours asleep. | Lifting, protein, pace and sleep are one system. The deficit without the lifting takes muscle; the lifting without the protein keeps little. | | A long way to go? | Beer belly or dad bod: the fast end of the pace, and the first 5 to 10% of body weight first. New to lifting: see [First muscle](https://elonmuscular.com/protocol-first-muscle/). Soft at a normal weight: see [Body recomposition](https://elonmuscular.com/protocol-body-recomp/). | With more to lose, a faster pace still keeps the muscle. | | Week 1 on | Creatine, 3 to 5 g a day. | The best-proven supplement for this goal, added alone so the log can credit it. | | Every week | Average down 0.5 to 1% and lifts holding: keep going. Falling faster or lifts sliding: eat a little more. Stuck two weeks: a little less food, or more steps. Sex drive gone, cold, dizzy: stop and eat at maintenance. | The weekly average sets the deficit. The stop signs override it. | | Evenings | If the diet breaks at night, see [Night cravings](https://elonmuscular.com/protocol-night-cravings/). Alcohol adds calories and cuts recovery: see [Drinking less](https://elonmuscular.com/protocol-drinking-less/). | Most cuts are lost in the evening, not at lunch. | | Weeks 8 to 12 | Long cut, hunger climbing: two refeed days a week, or a one-week diet break at maintenance. | Early trials: both kept lean mass better and eased hunger. | | Week 12, the review | Abs showing in the photos: stop the cut. Close: keep going at the slow end, 0.5% a week. Stuck: check the protein, the steps and the sleep before cutting food further. | Twelve weeks is where the tape, the photos and the log show the change clearly. | | After the cut | Ease food back up over a few weeks, mostly carbs, until the average holds. Keep lifting and the protein. Settle a little above your leanest. | The hormones and the burn recover while the waist holds. | | On a weight-loss medicine | The lifting and protein still come first. See [GLP-1 muscle](https://elonmuscular.com/protocol-glp1-muscle/). | The drugs take muscle along with fat unless the lifting and protein hold it. | ## What to track One number: the weekly average of your morning weight, falling 0.5 to 1% a week, slower as you get lean. The tape and the photos, once a week, say whether the loss is coming off the belly and whether the abs have arrived. The stop signs beside it, every week: sex drive, morning erections, feeling cold or dizzy, sleep, the lifts, and how much you think about food. Two or more, and the cut stops for a spell at maintenance. ### The log, one week Swipe sideways to see the whole table | Day | Morning weight | Lifting day? | Protein, grams | Steps | Hours asleep | Sex drive, 1 to 5 | | --- | -------------- | ------------ | -------------- | ----- | ------------ | ----------------- | | Mon | | | | | | | | Tue | | | | | | | | Wed | | | | | | | | Thu | | | | | | | | Fri | | | | | | | | Sat | | | | | | | | Sun | | | | | | | - Weekly average weight: 0.5 to 1% down a week. Over 1% means eat a little more. - Waist: every week, same time of day. Down is the goal. - Photos: every week, same light, spot and time. They decide when the abs have arrived. - The training log: every session. The lifts should hold. - Stop signs: sex drive, cold, dizzy, sleep, lifts, food thoughts. Two or more, stop the cut. ## Doses at a glance The amounts the studies used, move by move. The label or your doctor sets your dose. Swipe sideways to see the whole table | Move | What the studies used | When | How long | Study | | ------------------------------------------------------------------------ | ------------------------------------------------------------- | ----------------------------------------------- | ---------------------------------------------- | ------------------------------------------------------------------------------- | | [1\. Keep lifting heavy through the cut](#e1) | Each big muscle at least twice a week | 3 or 4 sessions a week | The whole cut, and after | [PMID 42144246](https://pubmed.ncbi.nlm.nih.gov/42144246/?ref=elonmuscular.com) | | [2\. Keep the sets up: about ten a muscle](#e2) | About 10 hard sets per muscle per week | Over 2 or more sessions | The whole cut | [PMID 35146569](https://pubmed.ncbi.nlm.nih.gov/35146569/?ref=elonmuscular.com) | | [3\. Train abs for strength and shape](#e3) | 2 or 3 loaded ab moves, 6 to 12 reps | Twice a week, after the main lifts | For good | [PMID 21804427](https://pubmed.ncbi.nlm.nih.gov/21804427/?ref=elonmuscular.com) | | [4\. The pace: 0.5 to 1% a week](#e4) | Up to 500 calories a day under maintenance | Every day | Adjust on the weekly average | [PMID 24864135](https://pubmed.ncbi.nlm.nih.gov/24864135/?ref=elonmuscular.com) | | [5\. Protein: 1 g per pound (2.2 g per kilo) or more](#e5) | 1 to 1.4 g per pound (2.2 to 3.0 g per kg) a day | Across the day | The whole cut | [PMID 34579132](https://pubmed.ncbi.nlm.nih.gov/34579132/?ref=elonmuscular.com) | | [6\. Protein at every meal, one around training](#e6) | 0.18 to 0.25 g per pound (0.4 to 0.55 g per kg) a meal | 3 to 6 meals; one before and one after training | For good | [PMID 34579132](https://pubmed.ncbi.nlm.nih.gov/34579132/?ref=elonmuscular.com) | | [7\. Carbs for training, some fat every day](#e7) | Fat 10 to 25% of calories; carbs to training | More carbs around training | The whole cut | [PMID 32148575](https://pubmed.ncbi.nlm.nih.gov/32148575/?ref=elonmuscular.com) | | [8\. Any eating style that holds the deficit](#e8) | The diet you will keep | Every day | For good | [PMID 28630601](https://pubmed.ncbi.nlm.nih.gov/28630601/?ref=elonmuscular.com) | | [9\. Walk more, and keep it up](#e9) | About 8,500 steps a day | Spread through the day | The whole cut, and after | [PMID 42466371](https://pubmed.ncbi.nlm.nih.gov/42466371/?ref=elonmuscular.com) | | [10\. Cardio on top of the lifting](#e10) | 150 minutes moderate or 75 vigorous a week | Lift first in the same session | For good | [PMID 42144246](https://pubmed.ncbi.nlm.nih.gov/42144246/?ref=elonmuscular.com) | | [11\. Sleep seven to nine hours](#e11) | 7 to 9 hours asleep | The same times, every day | For good | [PMID 20921542](https://pubmed.ncbi.nlm.nih.gov/20921542/?ref=elonmuscular.com) | | [12\. Creatine, 3 to 5 g a day](#e12) | 3 to 5 g a day; 20 g a day for 6 days to load | Any time, daily | Judge the log after a month | [PMID 42765482](https://pubmed.ncbi.nlm.nih.gov/42765482/?ref=elonmuscular.com) | | [13\. Whey, to hit the protein number](#e13) | 20 to 40 g of protein a shake | When food falls short; after training | The whole cut | [PMID 41368199](https://pubmed.ncbi.nlm.nih.gov/41368199/?ref=elonmuscular.com) | | [14\. Caffeine before a session, if you like it](#e14) | 3 to 6 mg per kg (1.4 to 2.7 mg per lb), 400 mg a day at most | About an hour before training | Same session | [PMID 33388079](https://pubmed.ncbi.nlm.nih.gov/33388079/?ref=elonmuscular.com) | | [15\. Psyllium before meals](#e15) | About 11 g a day | Just before meals, in a full glass of water | 4.8 months on average in the trials | [PMID 37163454](https://pubmed.ncbi.nlm.nih.gov/37163454/?ref=elonmuscular.com) | | [16\. Orlistat: the fat-blocking capsule](#e16) | 60 mg with each fatty main meal (120 mg on prescription) | Up to three times a day | Judge at 12 weeks | [PMID 14693982](https://pubmed.ncbi.nlm.nih.gov/14693982/?ref=elonmuscular.com) | | [17\. A lot to lose first: start with the belly](#e17) | Up to 1% of body weight a week | From week one | Judge the waist at 12 weeks | [PMID 34536199](https://pubmed.ncbi.nlm.nih.gov/34536199/?ref=elonmuscular.com) | | [18\. After the cut: ease the food back up](#e18) | Food back up gradually | Once the abs show | Over a few weeks | [PMID 23412685](https://pubmed.ncbi.nlm.nih.gov/23412685/?ref=elonmuscular.com) | | [19\. Two refeed days a week](#e19) | 2 days at maintenance, 5 days in deficit | Every week | 7 weeks in the trial | [PMID 33467235](https://pubmed.ncbi.nlm.nih.gov/33467235/?ref=elonmuscular.com) | | [20\. A one-week diet break](#e20) | One week at maintenance | After about 12 weeks of dieting | One week | [PMID 33630880](https://pubmed.ncbi.nlm.nih.gov/33630880/?ref=elonmuscular.com) | | [21\. Two weeks on, two weeks off](#e21) | 2 weeks in deficit, 2 at maintenance | Repeat the pairs | 16 weeks of dieting over 30 | [PMID 28925405](https://pubmed.ncbi.nlm.nih.gov/28925405/?ref=elonmuscular.com) | | [22\. HMB during the cut](#e22) | About 3 g a day | Daily, split with meals | 12 weeks in the trial | [PMID 42444106](https://pubmed.ncbi.nlm.nih.gov/42444106/?ref=elonmuscular.com) | | [23\. Beta-alanine, for the hard sessions](#e23) | 4 to 6 g a day, split into about 1.6 g doses | Spread through the day | At least 4 weeks | [PMID 22270875](https://pubmed.ncbi.nlm.nih.gov/22270875/?ref=elonmuscular.com) | | [24\. An 8-hour eating window](#e24) | All food within 8 hours | Every day | 8 weeks in the trial | [PMID 27737674](https://pubmed.ncbi.nlm.nih.gov/27737674/?ref=elonmuscular.com) | | [25\. Chili with meals](#e25) | Chili in meals | With meals | Daily, as food | [PMID 28001433](https://pubmed.ncbi.nlm.nih.gov/28001433/?ref=elonmuscular.com) | | [26\. L-carnitine, 2,000 mg a day](#e26) | 2,000 mg a day | Daily, with food | The whole cut | [PMID 32359762](https://pubmed.ncbi.nlm.nih.gov/32359762/?ref=elonmuscular.com) | | [27\. Green tea, the drink](#e27) | 3 or 4 cups | Between meals, before mid-afternoon | Every day | [PMID 19597519](https://pubmed.ncbi.nlm.nih.gov/19597519/?ref=elonmuscular.com) | | [28\. MCT oil in place of other fats](#e28) | 18 to 24 g a day, in place of other fats | With meals | The trial ran 16 weeks | [PMID 25636220](https://pubmed.ncbi.nlm.nih.gov/25636220/?ref=elonmuscular.com) | | [29\. Vinegar with meals](#e29) | 15 mL a day, diluted | With a meal | The trial ran 12 weeks | [PMID 19661687](https://pubmed.ncbi.nlm.nih.gov/19661687/?ref=elonmuscular.com) | | [30\. OEA, for hunger on the cut](#e30) | 125 to 250 mg | Daily, before meals | 8 weeks in the trials | [PMID 40469682](https://pubmed.ncbi.nlm.nih.gov/40469682/?ref=elonmuscular.com) | | [31\. Thylakoids, for hunger before a meal](#e31) | 5 g | 30 minutes before the main meal | Judge it inside 8 weeks | [PMID 38518202](https://pubmed.ncbi.nlm.nih.gov/38518202/?ref=elonmuscular.com) | | [32\. Tirzepatide: the strongest fat-loss shot, with a doctor](#e32) | 2.5 mg weekly to start; 5, 10 or 15 mg to keep | Once a week, same day | Judged at 72 weeks, kept long term | [PMID 35658024](https://pubmed.ncbi.nlm.nih.gov/35658024/?ref=elonmuscular.com) | | [33\. Semaglutide: the weekly shot or daily tablet, with a doctor](#e33) | 0.25 mg weekly to start; 1.7 or 2.4 mg to keep | Once a week, same day; or a daily tablet | Judged at 68 weeks, kept long term | [PMID 33567185](https://pubmed.ncbi.nlm.nih.gov/33567185/?ref=elonmuscular.com) | | [34\. Orforglipron: the daily GLP-1 tablet, with a doctor](#e34) | 0.8 mg a day to start; up to 17.2 mg | Once a day, with or without food | Steps every 30 days; judged at 72 weeks | [PMID 40960239](https://pubmed.ncbi.nlm.nih.gov/40960239/?ref=elonmuscular.com) | | [35\. Liraglutide 3 mg: the daily shot](#e35) | 0.6 mg a day to start; 3 mg to keep | Once a day, any time | Judge at 16 weeks | [PMID 26132939](https://pubmed.ncbi.nlm.nih.gov/26132939/?ref=elonmuscular.com) | | [36\. Naltrexone-bupropion: the craving tablet](#e36) | One tablet, rising to two twice a day | Morning and evening, never with a fatty meal | Judge at 12 weeks on the full dose | [PMID 20673995](https://pubmed.ncbi.nlm.nih.gov/20673995/?ref=elonmuscular.com) | | [37\. Phentermine-topiramate: the US once-daily capsule](#e37) | 3.75/23 mg to start; 7.5/46 mg to keep | Each morning | Judge at 12 weeks, again at 12 on the top dose | [PMID 24136928](https://pubmed.ncbi.nlm.nih.gov/24136928/?ref=elonmuscular.com) | | [38\. Phentermine: a few weeks, US only](#e38) | 37.5 mg each morning, or 8 mg up to three times a day | Morning, or half an hour before meals | A few weeks only | [PMID 24136928](https://pubmed.ncbi.nlm.nih.gov/24136928/?ref=elonmuscular.com) | | [39\. Balloon or endoscopic sleeve: through the mouth, no cuts](#e39) | One procedure | Through a specialist or endoscopy team | Judged at 6 to 12 months | [PMID 35908555](https://pubmed.ncbi.nlm.nih.gov/35908555/?ref=elonmuscular.com) | | [40\. Weight-loss surgery: ask for the referral](#e40) | A referral to a specialist weight service | At a BMI of 40, or 35 with a condition | Assessment first, lifelong follow-up after | [PMID 24149519](https://pubmed.ncbi.nlm.nih.gov/24149519/?ref=elonmuscular.com) | | [41\. Surgery: the risks and the lifelong checks](#e41) | Vitamins, minerals and yearly checks | From the day of surgery | For life | [PMID 19641201](https://pubmed.ncbi.nlm.nih.gov/19641201/?ref=elonmuscular.com) | | [42\. Testosterone therapy, if a doctor confirms it is low](#e42) | Doctor-set, to the middle of the normal range | Daily, as prescribed | Ongoing | [PMID 26537862](https://pubmed.ncbi.nlm.nih.gov/26537862/?ref=elonmuscular.com) | ## Deep dives Each of these has its own page in the library, with its risks, its doses and every study. - [**Keep lifting heavy through the cut**Every big muscle, twice a week, heavy](https://elonmuscular.com/resistance-training/) - [**Keep the sets up: about ten a muscle**Ten or more hard sets per muscle, kept up](https://elonmuscular.com/lab-mev-mav-mrv/) - [**The pace: 0.5 to 1% a week**0.5 to 1% a week, slower as you get lean](https://elonmuscular.com/calorie-restriction/) - [**Sleep seven to nine hours**Seven to nine hours, at the same times](https://elonmuscular.com/sleep/) - [**Creatine, 3 to 5 g a day**3 to 5 g of creatine monohydrate, every day](https://elonmuscular.com/creatine/) - [**Whey, to hit the protein number**A whey shake when food falls short](https://elonmuscular.com/whey-protein-concentrate/) - [**Caffeine before a session, if you like it**Optional: 3 to 6 mg per kilo (1.4 to 2.7 mg per lb) before training, 400 mg a day at most](https://elonmuscular.com/caffeine/) - [**Psyllium before meals**Psyllium, about 11 g a day, just before meals](https://elonmuscular.com/psyllium-seed-husks/) - [**HMB during the cut**About 3 g of HMB a day while cutting](https://elonmuscular.com/hmb/) - [**Beta-alanine, for the hard sessions**Optional: 4 to 6 g a day, split](https://elonmuscular.com/beta-alanine/) - [**Chili with meals**Optional: chili in your meals](https://elonmuscular.com/capsaicin/) - [**L-carnitine, 2,000 mg a day**Early research: L-carnitine, 2,000 mg a day](https://elonmuscular.com/l-carnitine/) - [**Green tea, the drink**Early research: green tea, the drink, not the extract](https://elonmuscular.com/green-tea/) - [**MCT oil in place of other fats**Early research: MCT oil in place of other fats](https://elonmuscular.com/medium-chain-triglycerides/) - [**Vinegar with meals**Early research: 15 mL of vinegar a day, diluted, with a meal](https://elonmuscular.com/apple-cider-vinegar/) - [**OEA, for hunger on the cut**Early research: OEA, 125 to 250 mg a day](https://elonmuscular.com/oleoylethanolamide/) - [**Thylakoids, for hunger before a meal**Early research: thylakoids, 5 g before the main meal](https://elonmuscular.com/thylakoids/) - [**Tirzepatide: the strongest fat-loss shot, with a doctor**A weekly shot, stepped up every 4 weeks](https://elonmuscular.com/tirzepatide/) - [**Semaglutide: the weekly shot or daily tablet, with a doctor**A weekly shot, stepped up every 4 weeks to 2.4 mg](https://elonmuscular.com/semaglutide/) - [**Liraglutide 3 mg: the daily shot**A daily shot, stepped up weekly to 3 mg](https://elonmuscular.com/liraglutide/) - [**Testosterone therapy, if a doctor confirms it is low**Only when two morning tests and the symptoms agree](https://elonmuscular.com/male-hrt/) ## The studies Every study behind this page, newest first. - [Assessing body composition via a smartphone computer vision application: High repeatability but method-dependent agreement compared with BODPOD and Inbody.PLOS digital health, 2026\. PMID 42685095](https://pubmed.ncbi.nlm.nih.gov/42685095/?ref=elonmuscular.com) - [Endocrinological aspects of sarcopenic obesity.Annals of medicine, 2026\. PMID 41649890](https://pubmed.ncbi.nlm.nih.gov/41649890/?ref=elonmuscular.com) - [Effects of Calorie Restriction With and Without Strength, Endurance or Mixed Training on Fat-Free and Skeletal Muscle Mass in Overweight or Obese Individuals-A Systematic Review With Pairwise Meta-Analysis and Network Meta-Analysis of Randomized Controlled Studies.Diabetes, obesity & metabolism, 2026\. PMID 42144246](https://pubmed.ncbi.nlm.nih.gov/42144246/?ref=elonmuscular.com) - [Weight Loss Plateau: Reasons, Challenges, and Solutions: A Narrative Review.Health science reports, 2026\. PMID 42466371](https://pubmed.ncbi.nlm.nih.gov/42466371/?ref=elonmuscular.com) - [Resistance training combined with creatine supplementation: a three-level meta-analysis of multidimensional outcomes from strength enhancement to body composition remodeling.Journal of the International Society of Sports Nutrition, 2026\. PMID 42765482](https://pubmed.ncbi.nlm.nih.gov/42765482/?ref=elonmuscular.com) - [Calcium Beta-Hydroxy-Beta-Methylbutyrate-Enriched Nutritional Supplementation During Dietary Weight Loss in Adults With Obesity: A Randomized Controlled Trial.Journal of cachexia, sarcopenia and muscle, 2026\. PMID 42444106](https://pubmed.ncbi.nlm.nih.gov/42444106/?ref=elonmuscular.com) - [Advances in the estimation of body fat percentage using an artificial intelligence 2D-photo method.NPJ digital medicine, 2025\. PMID 39827323](https://pubmed.ncbi.nlm.nih.gov/39827323/?ref=elonmuscular.com) - [Dietary Recommendations for Body Mass and Composition Manipulation in Male and Female Athletes: a Scoping Review of Consensus Statements, Position Stands and Practice Guidelines from International Expert Groups.Sports medicine (Auckland, N.Z.), 2025\. PMID 40841871](https://pubmed.ncbi.nlm.nih.gov/40841871/?ref=elonmuscular.com) - [Dietary supplement considerations during glucagon-like Peptide-1 receptor agonist treatment: A narrative review.Obesity pillars, 2025\. PMID 41368199](https://pubmed.ncbi.nlm.nih.gov/41368199/?ref=elonmuscular.com) - [International society of sports nutrition position stand: β-hydroxy-β-methylbutyrate (HMB).Journal of the International Society of Sports Nutrition, 2025\. PMID 39699070](https://pubmed.ncbi.nlm.nih.gov/39699070/?ref=elonmuscular.com) - [Effect of Apple Cider Vinegar Intake on Body Composition in Humans with Type 2 Diabetes and/or Overweight: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Nutrients, 2025\. PMID 41010525](https://pubmed.ncbi.nlm.nih.gov/41010525/?ref=elonmuscular.com) - [Oleoylethanolamide supplementation on cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials.Frontiers in nutrition, 2025\. PMID 40469682](https://pubmed.ncbi.nlm.nih.gov/40469682/?ref=elonmuscular.com) - [The effect of oleoylethanolamide supplementation on cardiometabolic factors: a systematic review and meta-analysis.Cardiovascular endocrinology & metabolism, 2025\. PMID 40661161](https://pubmed.ncbi.nlm.nih.gov/40661161/?ref=elonmuscular.com) - [Thylakoid supplementation and hunger and fullness perception: a systematic review and dose-response meta-analysis of randomized controlled trials.Nutrition reviews, 2025\. PMID 38518202](https://pubmed.ncbi.nlm.nih.gov/38518202/?ref=elonmuscular.com) - [Tirzepatide as Compared with Semaglutide for the Treatment of Obesity.The New England journal of medicine, 2025\. PMID 40353578](https://pubmed.ncbi.nlm.nih.gov/40353578/?ref=elonmuscular.com) - [Orforglipron, an Oral Small-Molecule GLP-1 Receptor Agonist for Obesity Treatment.The New England journal of medicine, 2025\. PMID 40960239](https://pubmed.ncbi.nlm.nih.gov/40960239/?ref=elonmuscular.com) - [Intragastric balloon for obesity treatment: Systematic review and meta-analysis of randomized controlled trials.Endoscopy international open, 2025\. PMID 40932823](https://pubmed.ncbi.nlm.nih.gov/40932823/?ref=elonmuscular.com) - [Pharmacotherapy causing weight gain and metabolic alteration in those with obesity and obesity-related conditions: A review.Annals of the New York Academy of Sciences, 2024\. PMID 38385953](https://pubmed.ncbi.nlm.nih.gov/38385953/?ref=elonmuscular.com) - [Resistance training prescription for muscle strength and hypertrophy in healthy adults: a systematic review and Bayesian network meta-analysis.British journal of sports medicine, 2023\. PMID 37414459](https://pubmed.ncbi.nlm.nih.gov/37414459/?ref=elonmuscular.com) - [Psyllium is a natural nonfermented gel-forming fiber that is effective for weight loss: A comprehensive review and meta-analysis.Journal of the American Association of Nurse Practitioners, 2023\. PMID 37163454](https://pubmed.ncbi.nlm.nih.gov/37163454/?ref=elonmuscular.com) - [Screening for Low Energy Availability in Male Athletes: Attempted Validation of LEAM-Q.Nutrients, 2022\. PMID 35565840](https://pubmed.ncbi.nlm.nih.gov/35565840/?ref=elonmuscular.com) - [Diagnostic accuracy of screening questionnaires for obstructive sleep apnoea in adults in different clinical cohorts: a systematic review and meta-analysis.Sleep & breathing = Schlaf & Atmung, 2022\. PMID 34406554](https://pubmed.ncbi.nlm.nih.gov/34406554/?ref=elonmuscular.com) - [Lean mass sparing in resistance-trained athletes during caloric restriction: the role of resistance training volume.European journal of applied physiology, 2022\. PMID 35146569](https://pubmed.ncbi.nlm.nih.gov/35146569/?ref=elonmuscular.com) - [The Effect of Resistance Training in Healthy Adults on Body Fat Percentage, Fat Mass and Visceral Fat: A Systematic Review and Meta-Analysis.Sports medicine (Auckland, N.Z.), 2022\. PMID 34536199](https://pubmed.ncbi.nlm.nih.gov/34536199/?ref=elonmuscular.com) - [Tirzepatide Once Weekly for the Treatment of Obesity.The New England journal of medicine, 2022\. PMID 35658024](https://pubmed.ncbi.nlm.nih.gov/35658024/?ref=elonmuscular.com) - [Endoscopic sleeve gastroplasty for treatment of class 1 and 2 obesity (MERIT): a prospective, multicentre, randomised trial.Lancet (London, England), 2022\. PMID 35908555](https://pubmed.ncbi.nlm.nih.gov/35908555/?ref=elonmuscular.com) - [Achieving an Optimal Fat Loss Phase in Resistance-Trained Athletes: A Narrative Review.Nutrients, 2021\. PMID 34579132](https://pubmed.ncbi.nlm.nih.gov/34579132/?ref=elonmuscular.com) - [International society of sports nutrition position stand: caffeine and exercise performance.Journal of the International Society of Sports Nutrition, 2021\. PMID 33388079](https://pubmed.ncbi.nlm.nih.gov/33388079/?ref=elonmuscular.com) - [A 1-week diet break improves muscle endurance during an intermittent dieting regime in adult athletes: A pre-specified secondary analysis of the ICECAP trial.PloS one, 2021\. PMID 33630880](https://pubmed.ncbi.nlm.nih.gov/33630880/?ref=elonmuscular.com) - [Once-Weekly Semaglutide in Adults with Overweight or Obesity.The New England journal of medicine, 2021\. PMID 33567185](https://pubmed.ncbi.nlm.nih.gov/33567185/?ref=elonmuscular.com) - [Healthy Weight Loss Maintenance with Exercise, Liraglutide, or Both Combined.The New England journal of medicine, 2021\. PMID 33951361](https://pubmed.ncbi.nlm.nih.gov/33951361/?ref=elonmuscular.com) - [Laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy: 5-year outcomes of merged data from two randomized clinical trials (SLEEVEPASS and SM-BOSS).The British journal of surgery, 2021\. PMID 33640917](https://pubmed.ncbi.nlm.nih.gov/33640917/?ref=elonmuscular.com) - [Waist circumference as a vital sign in clinical practice: a Consensus Statement from the IAS and ICCR Working Group on Visceral Obesity.Nature reviews. Endocrinology, 2020\. PMID 32020062](https://pubmed.ncbi.nlm.nih.gov/32020062/?ref=elonmuscular.com) - [Nutritional Recommendations for Physique Athletes.Journal of human kinetics, 2020\. PMID 32148575](https://pubmed.ncbi.nlm.nih.gov/32148575/?ref=elonmuscular.com) - [Intermittent Energy Restriction Attenuates the Loss of Fat Free Mass in Resistance Trained Individuals. A Randomized Controlled Trial.Journal of functional morphology and kinesiology, 2020\. PMID 33467235](https://pubmed.ncbi.nlm.nih.gov/33467235/?ref=elonmuscular.com) - [Effects of l-carnitine supplementation on weight loss and body composition: A systematic review and meta-analysis of 37 randomized controlled clinical trials with dose-response analysis.Clinical nutrition ESPEN, 2020\. PMID 32359762](https://pubmed.ncbi.nlm.nih.gov/32359762/?ref=elonmuscular.com) - [Towards a Sustainable Nutrition Paradigm in Physique Sport: A Narrative Review.Sports (Basel, Switzerland), 2019\. PMID 31315180](https://pubmed.ncbi.nlm.nih.gov/31315180/?ref=elonmuscular.com) - [How much protein can the body use in a single meal for muscle-building? Implications for daily protein distribution.Journal of the International Society of Sports Nutrition, 2018\. PMID 29497353](https://pubmed.ncbi.nlm.nih.gov/29497353/?ref=elonmuscular.com) - [Sleep extension is a feasible lifestyle intervention in free-living adults who are habitually short sleepers: a potential strategy for decreasing intake of free sugars? A randomized controlled pilot study.The American journal of clinical nutrition, 2018\. PMID 29381788](https://pubmed.ncbi.nlm.nih.gov/29381788/?ref=elonmuscular.com) - [Intermittent energy restriction improves weight loss efficiency in obese men: the MATADOR study.International journal of obesity (2005), 2018\. PMID 28925405](https://pubmed.ncbi.nlm.nih.gov/28925405/?ref=elonmuscular.com) - [Capsaicin and capsiate could be appropriate agents for treatment of obesity: A meta-analysis of human studies.Critical reviews in food science and nutrition, 2018\. PMID 28001433](https://pubmed.ncbi.nlm.nih.gov/28001433/?ref=elonmuscular.com) - [Case Study: Unfavorable But Transient Physiological Changes During Contest Preparation in a Drug-Free Male Bodybuilder.International journal of sport nutrition and exercise metabolism, 2017\. PMID 28770669](https://pubmed.ncbi.nlm.nih.gov/28770669/?ref=elonmuscular.com) - [Cardiovascular Toxicity of Illicit Anabolic-Androgenic Steroid Use.Circulation, 2017\. PMID 28533317](https://pubmed.ncbi.nlm.nih.gov/28533317/?ref=elonmuscular.com) - [Dose-response relationship between weekly resistance training volume and increases in muscle mass: A systematic review and meta-analysis.Journal of sports sciences, 2017\. PMID 27433992](https://pubmed.ncbi.nlm.nih.gov/27433992/?ref=elonmuscular.com) - [International society of sports nutrition position stand: diets and body composition.Journal of the International Society of Sports Nutrition, 2017\. PMID 28630601](https://pubmed.ncbi.nlm.nih.gov/28630601/?ref=elonmuscular.com) - [International Society of Sports Nutrition Position Stand: protein and exercise.Journal of the International Society of Sports Nutrition, 2017\. PMID 28642676](https://pubmed.ncbi.nlm.nih.gov/28642676/?ref=elonmuscular.com) - [β-alanine supplementation to improve exercise capacity and performance: a systematic review and meta-analysis.British journal of sports medicine, 2017\. PMID 27797728](https://pubmed.ncbi.nlm.nih.gov/27797728/?ref=elonmuscular.com) - [Higher compared with lower dietary protein during an energy deficit combined with intense exercise promotes greater lean mass gain and fat mass loss: a randomized trial.The American journal of clinical nutrition, 2016\. PMID 26817506](https://pubmed.ncbi.nlm.nih.gov/26817506/?ref=elonmuscular.com) - [Former Abusers of Anabolic Androgenic Steroids Exhibit Decreased Testosterone Levels and Hypogonadal Symptoms Years after Cessation: A Case-Control Study.PloS one, 2016\. PMID 27532478](https://pubmed.ncbi.nlm.nih.gov/27532478/?ref=elonmuscular.com) - [Effects of eight weeks of time-restricted feeding (16/8) on basal metabolism, maximal strength, body composition, inflammation, and cardiovascular risk factors in resistance-trained males.Journal of translational medicine, 2016\. PMID 27737674](https://pubmed.ncbi.nlm.nih.gov/27737674/?ref=elonmuscular.com) - [THERAPY OF ENDOCRINE DISEASE: Testosterone supplementation and body composition: results from a meta-analysis study.European journal of endocrinology, 2016\. PMID 26537862](https://pubmed.ncbi.nlm.nih.gov/26537862/?ref=elonmuscular.com) - [Effects of medium-chain triglycerides on weight loss and body composition: a meta-analysis of randomized controlled trials.Journal of the Academy of Nutrition and Dietetics, 2015\. PMID 25636220](https://pubmed.ncbi.nlm.nih.gov/25636220/?ref=elonmuscular.com) - [A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management.The New England journal of medicine, 2015\. PMID 26132939](https://pubmed.ncbi.nlm.nih.gov/26132939/?ref=elonmuscular.com) - [Case study: Natural bodybuilding contest preparation.International journal of sport nutrition and exercise metabolism, 2014\. PMID 24901578](https://pubmed.ncbi.nlm.nih.gov/24901578/?ref=elonmuscular.com) - [Evidence-based recommendations for natural bodybuilding contest preparation: nutrition and supplementation.Journal of the International Society of Sports Nutrition, 2014\. PMID 24864135](https://pubmed.ncbi.nlm.nih.gov/24864135/?ref=elonmuscular.com) - [Natural bodybuilding competition preparation and recovery: a 12-month case study.International journal of sports physiology and performance, 2013\. PMID 23412685](https://pubmed.ncbi.nlm.nih.gov/23412685/?ref=elonmuscular.com) - [Regional fat changes induced by localized muscle endurance resistance training.Journal of strength and conditioning research, 2013\. PMID 23222084](https://pubmed.ncbi.nlm.nih.gov/23222084/?ref=elonmuscular.com) - [Evaluation of phentermine and topiramate versus phentermine/topiramate extended-release in obese adults.Obesity (Silver Spring, Md.), 2013\. PMID 24136928](https://pubmed.ncbi.nlm.nih.gov/24136928/?ref=elonmuscular.com) - [Bariatric surgery versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomised controlled trials.BMJ (Clinical research ed.), 2013\. PMID 24149519](https://pubmed.ncbi.nlm.nih.gov/24149519/?ref=elonmuscular.com) - [Hypokalemic paralysis in a professional bodybuilder.The American journal of emergency medicine, 2012\. PMID 21871759](https://pubmed.ncbi.nlm.nih.gov/21871759/?ref=elonmuscular.com) - [Effects of β-alanine supplementation on exercise performance: a meta-analysis.Amino acids, 2012\. PMID 22270875](https://pubmed.ncbi.nlm.nih.gov/22270875/?ref=elonmuscular.com) - [Capsaicinoids and capsinoids. A potential role for weight management? A systematic review of the evidence.Appetite, 2012\. PMID 22634197](https://pubmed.ncbi.nlm.nih.gov/22634197/?ref=elonmuscular.com) - [The effect of abdominal exercise on abdominal fat.Journal of strength and conditioning research, 2011\. PMID 21804427](https://pubmed.ncbi.nlm.nih.gov/21804427/?ref=elonmuscular.com) - [Effect of two different weight-loss rates on body composition and strength and power-related performance in elite athletes.International journal of sport nutrition and exercise metabolism, 2011\. PMID 21558571](https://pubmed.ncbi.nlm.nih.gov/21558571/?ref=elonmuscular.com) - [Insufficient sleep undermines dietary efforts to reduce adiposity.Annals of internal medicine, 2010\. PMID 20921542](https://pubmed.ncbi.nlm.nih.gov/20921542/?ref=elonmuscular.com) - [Effect of naltrexone plus bupropion on weight loss in overweight and obese adults (COR-I): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial.Lancet (London, England), 2010\. PMID 20673995](https://pubmed.ncbi.nlm.nih.gov/20673995/?ref=elonmuscular.com) - [American College of Sports Medicine position stand. Progression models in resistance training for healthy adults.Medicine and science in sports and exercise, 2009\. PMID 19204579](https://pubmed.ncbi.nlm.nih.gov/19204579/?ref=elonmuscular.com) - [The effects of green tea on weight loss and weight maintenance: a meta-analysis.International journal of obesity (2005), 2009\. PMID 19597519](https://pubmed.ncbi.nlm.nih.gov/19597519/?ref=elonmuscular.com) - [Vinegar intake reduces body weight, body fat mass, and serum triglyceride levels in obese Japanese subjects.Bioscience, biotechnology, and biochemistry, 2009\. PMID 19661687](https://pubmed.ncbi.nlm.nih.gov/19661687/?ref=elonmuscular.com) - [Perioperative safety in the longitudinal assessment of bariatric surgery.The New England journal of medicine, 2009\. PMID 19641201](https://pubmed.ncbi.nlm.nih.gov/19641201/?ref=elonmuscular.com) - [Weight-loss diet that includes consumption of medium-chain triacylglycerol oil leads to a greater rate of weight and fat mass loss than does olive oil.The American journal of clinical nutrition, 2008\. PMID 18326600](https://pubmed.ncbi.nlm.nih.gov/18326600/?ref=elonmuscular.com) - [Effects of bariatric surgery on mortality in Swedish obese subjects.The New England journal of medicine, 2007\. PMID 17715408](https://pubmed.ncbi.nlm.nih.gov/17715408/?ref=elonmuscular.com) - [Evaluation of type 3 portable monitoring in unattended home setting for suspected sleep apnea: factors that may affect its accuracy.Otolaryngology--head and neck surgery, 2006\. PMID 16455365](https://pubmed.ncbi.nlm.nih.gov/16455365/?ref=elonmuscular.com) - [XENical in the prevention of diabetes in obese subjects (XENDOS) study: a randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients.Diabetes care, 2004\. PMID 14693982](https://pubmed.ncbi.nlm.nih.gov/14693982/?ref=elonmuscular.com) - [Role of nonexercise activity thermogenesis in resistance to fat gain in humans.Science (New York, N.Y.), 1999\. PMID 9880251](https://pubmed.ncbi.nlm.nih.gov/9880251/?ref=elonmuscular.com) ## Words on this page Standardized mean difference (SMD) A way to put results measured on different scales onto one scale. About 0.2 is a small effect, 0.5 medium and 0.8 large. 95% CI The range the true result probably sits in. The narrower the range, the surer the result. Meta-analysis Many studies pooled into one result. RCT A randomized controlled trial: people put by chance on the treatment or on a dummy version. PMID A study's ID number in PubMed, the public index of medical research. Strong, moderate and early evidence Strong: many human trials agree. Moderate: human studies point the same way. Early: the first small human studies. Cut A block of eating a little less than you burn, to lose fat while keeping muscle. Calorie deficit Eating less energy than you burn, so the body uses stored fat to cover the gap. Maintenance The amount of food that holds your weight steady. Weekly average Your morning weights for 7 days, added up and divided by 7. Stage lean The very low body fat of a physique contest, held for a day, far leaner than visible abs need. Low energy availability Too little food left over after training to run the body, which turns down hormones, bone building and recovery. RED-S Relative energy deficiency in sport: the health problems that too little fuel for the training causes. Refeed A planned day or two of eating at maintenance, mostly carbs, inside a cut. Diet break A planned week or more of eating at maintenance in the middle of a long cut. Hard set A set taken close to failure, ending with only one or two good reps left. NEAT The energy you burn moving outside exercise: walking, standing, fidgeting. Lean mass Everything in the body that is not fat: muscle, bone, organs and water. Diuretic A water pill: a medicine that makes you pee out water and salts. Take your photos and tape your waist tomorrow morning, and weigh every morning this week. Lift heavy three or four times, every muscle twice, and train the abs for strength and shape. Protein at 1 g per pound (2.2 g per kilo) or more, a little less food, more walking, and seven to nine hours asleep. The fat will come off everywhere. When the abs show, stop, and ease the food back up. ## Not this? Try - [**Lose Fat and Build Muscle**Losing fat and building muscle at once, for the soft-at-a-normal-weight start.](https://elonmuscular.com/protocol-body-recomp/) - [**Build Your First Muscle**Building the first muscle: the full lifting plan for a beginner.](https://elonmuscular.com/protocol-first-muscle/) - [**Stop Eating at Night**When the diet breaks in the evening.](https://elonmuscular.com/protocol-night-cravings/) - [**Keep Your Muscle on GLP-1**Keeping the muscle on a weight-loss medicine.](https://elonmuscular.com/protocol-glp1-muscle/) - [**Drink Less**Alcohol: the calories and the lost recovery.](https://elonmuscular.com/protocol-drinking-less/) - [**Sleep Deeper**The sleep that decides how much of the loss is fat.](https://elonmuscular.com/protocol-deeper-sleep/) When to see a doctor - Using laxatives or diuretics, making yourself sick, or skipping food for long spells to control your weight: see your doctor. - Bingeing after strict dieting, eating when not hungry and unable to stop: see your doctor as soon as you can. - Eating very little, worrying about your weight or shape much of the day, or exercising too much: see your doctor soon. - Never feeling lean or big enough, whatever you see: see your doctor. - Using anabolic steroids or fat-loss drugs, now or before, or feeling hooked on them: see your doctor. - Very tired, feeling cold, putting on weight and constipated: see your doctor for a thyroid blood test. - Taking a medicine that may add weight, such as some steroids, antidepressants or beta blockers: talk to your doctor. - Breathing that stops and starts in your sleep, gasping, and tired all day: see your doctor about sleep apnea. - You have not exercised for some time, or you have a medical condition: speak to your doctor first. I am not a doctor. This is not medical advice. This is self-education. Every dose on this page is the one a trial or a position stand used, quoted from the source. It is not a prescription. See a doctor first about anything on the Check first and When to see a doctor lists. New Heroes The full library. Elon answers every weekday. [Join New Heroes.](https://elonmuscular.com/join/) Cancel anytime.