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NICE-recommended weight management strategies include: Dietary intervention aiming for a 600 kcal/day deficit through reduced portion sizes, limiting energy-dense foods, and increasing fruit and vegetable consumption Physical activity building up to 150300 minutes of moderate-intensity aerobic activity weekly, plus muscle-strengthening activities on at least two days weekly, in line with UK Chief Medical Officers' guidelines [10] Behavioural approaches including self-monitoring, goal-setting, and addressing emotional eating patterns Commercial weight management programmes such as those meeting NICE quality standards (QS127) Very-low-calorie diets in specific circumstances, under clinical supervision and for limited periods For patients with a BMI 30 kg/m (or 27.5 kg/m in those of South Asian, Chinese, or other Asian family origin) who have not achieved adequate weight loss through lifestyle measures alone, pharmacological interventions may be considered

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Sabato reports grants and personal fees from Blueprint, grants and personal fees from Cogent, grants and personal fees from Novartis, grants from Thermo Fisher, and grants from AB Science, during the conduct of the study

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