The best-evidenced way to hold weight off is still a lighter Mediterranean plate

Using GLP-1 drugs to lose weight without changing what you eat or how you move is a total mistake, says Jordi Salas-Salvadó, professor of nutrition at the Rovira i Virgili University and head of the nutrition programme at Spain's obesity research network. He welcomes the drugs and expects them to help many people, and he also says their use has turned irrational.

What he wants underneath them is a slightly lower-calorie Mediterranean diet plus activity, the pattern with the most evidence for weight control, built on PREDIMED 1 and PREDIMED Plus and tested against Nordic and vegetarian diets. Adherence is scored on a 14-point scale and climbs after 55, especially among women.

Skip that base and appetite still drops and weight still comes off, but it returns once the drug stops, and lean mass and strength go with it, which lands hardest on older people. Protein, vitamins and minerals on the plate are his answer. Where any of it fits belongs with a qualified clinician who knows a person's health history.

Shortcuts keep arriving and the evidence keeps declining to follow: in a review he co-authored, alternate-day fasting beat a standard reduced-calorie diet only slightly, and only in the short term. Processed food consumption tripled over two decades, and no injection reaches that.

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