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Evidence-based weight management recommendations prioritise: Achieving a sustainable calorie deficit through dietary modification (typically 500-600 kcal/day reduction) as recommended by NICE guideline NG246 Increasing physical activity to at least 150 minutes of moderate-intensity exercise weekly, in line with UK Chief Medical Officers' Physical Activity Guidelines Behavioural strategies including self-monitoring, goal-setting, and addressing psychological factors Consideration of NHS weight management services based on local referral criteria, typically for those with BMI 30 kg/m (or 27.5 kg/m for South Asian, Chinese, and other minority ethnic groups) with comorbidities If choosing to trial probiotic supplementation, select products that specify the bacterial strains and colony-forming units (CFUs) on the label

This is why research protocols must be carefully designed with appropriate cycles to mitigate this risk

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Abdel Fattah NSA, Ebrahim AA, El Okda ES

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