New weight-loss medications called GLP-1 receptor agonists have changed the way doctors treat obesity.
Drugs such as semaglutide and liraglutide have helped many people lose large amounts of weight, sometimes more effectively than older treatments. Because of these results, the medications have quickly become some of the most talked-about drugs in the world.
But even as these medications transform obesity care, doctors say there is still one major challenge that medicine alone cannot fully solve: helping people stay physically active in ways they can continue long term.
A new medical perspective published in the journal JAMA explores this growing issue. The article was written by researchers including Dr. Steven Heymsfield from Pennington Biomedical Research Center and Harvard researchers Dr. Daniel Lieberman and Dr. Daniel Aslan.
The researchers explain that while GLP-1 medications are powerful tools for weight loss, exercise remains essential for overall health and long-term success.
GLP-1 receptor agonists work mainly by reducing appetite. These medications help people feel full sooner and eat less food. Studies have shown that they can reduce calorie intake by as much as 39 percent.
This reduction in food intake is one reason the medications often lead to significant weight loss. In comparison, standard exercise recommendations such as 150 minutes of physical activity per week usually burn far fewer calories than the calorie reductions caused by these drugs.
Because of this, some people may wonder whether exercise is still necessary if medications can produce large weight loss on their own.
The researchers strongly argue that exercise remains critically important because its benefits go far beyond simply burning calories.
Physical activity improves insulin sensitivity, which helps the body control blood sugar more effectively. Exercise also helps the body burn fat more efficiently and improves heart health, blood pressure, mental well-being, sleep quality, and physical fitness.
Perhaps most importantly, exercise helps preserve muscle mass.
This is especially important because scientists have become concerned that a significant portion of weight lost during GLP-1 treatment may come not only from body fat but also from fat-free mass, including muscle tissue.
Losing too much muscle can create serious health problems, especially in older adults. Muscle loss may increase weakness, frailty, reduced mobility, balance problems, and risk of falls. Severe muscle loss is sometimes called sarcopenia.
The researchers say exercise, especially resistance training and strength exercises, may help protect muscle during weight loss treatment.
Another major concern discussed in the JAMA perspective is that many people stop taking GLP-1 medications over time.
Studies show that as many as 60 percent of patients discontinue these medications within one year. There are many possible reasons, including cost, side effects, limited access, insurance problems, or difficulty staying on long-term treatment.
Unfortunately, when people stop the medications, many regain a significant amount of the weight they had lost.
The researchers explain that regular physical activity may help reduce this weight regain and improve the chances of maintaining healthier body weight after treatment.
Even though exercise offers many benefits, doctors recognize that staying active is often difficult in real life.
Many people struggle with lack of time, busy schedules, chronic pain, physical limitations, low motivation, fatigue, lack of safe places to exercise, or limited access to fitness facilities.
Some people also simply find exercise unpleasant or emotionally discouraging, especially if they have struggled with weight for many years.
Because of these challenges, the researchers say healthcare providers need to move beyond simply telling patients to “exercise more.”
Instead, doctors should help patients develop realistic and personalized activity plans that fit their daily lives and physical abilities.
The article encourages clinicians to assess each person’s current activity level, identify barriers to movement, and help patients discover forms of exercise they actually enjoy and can continue long term.
For some people, this may mean walking regularly. Others may prefer swimming, dancing, cycling, gardening, strength training, yoga, or other forms of movement.
The researchers emphasize that sustainable movement is more important than forcing people into exercise programs they dislike and eventually abandon.
The article also highlights an important shift in obesity treatment. Historically, many weight-loss programs focused almost entirely on calorie balance and body weight numbers.
Today, experts increasingly recognize that obesity is a complex chronic disease involving metabolism, hormones, appetite regulation, mental health, lifestyle, and social factors.
Because of this complexity, successful long-term treatment likely requires combining medications, healthy eating, exercise, sleep, stress management, and behavioral support.
The researchers believe GLP-1 medications should complement exercise, not replace it.
If you care about weight loss, please read studies that hop extract could reduce belly fat in overweight people, and early time-restricted eating could help lose weight .
For more health information, please see recent studies about a simple path to weight loss, and results showing a non-invasive treatment for obesity and diabetes.
The perspective was published in JAMA.
Source: Pennington Biomedical Research Center.
