New medications for obesity and type 2 diabetes have dramatically changed the conversation about weight loss.
Drugs known as GLP-1 receptor agonists, including semaglutide and liraglutide, are helping many people lose far more weight than was previously possible with older medications alone.
These drugs work mainly by reducing appetite and helping people feel full longer after eating. Many patients taking these medications naturally eat fewer calories and lose substantial amounts of weight.
Because of their success, some experts have started asking an important question: If these medications work so well, does exercise still matter as much as before?
According to a new medical perspective published in JAMA, the answer is clearly yes.
The article was written by researchers from Pennington Biomedical Research Center and Harvard University, including Dr. Steven Heymsfield, Dr. Daniel Lieberman, and Dr. Daniel Aslan.
The researchers explain that while GLP-1 drugs are highly effective for weight loss, physical activity continues to play a critical role in maintaining health and supporting long-term weight management.
The medications can reduce calorie intake by nearly 40 percent, which is much greater than the number of calories burned during the standard recommendation of 150 minutes of weekly exercise.
However, the researchers say focusing only on calories misses the much bigger picture of what exercise actually does for the body.
Exercise affects many important systems beyond body weight. Physical activity improves blood sugar control, strengthens the heart, improves circulation, lowers blood pressure, supports mental health, improves sleep, and helps the body use fat more effectively.
One of the most important concerns discussed in the article is muscle loss.
When people lose weight quickly, they often lose not only fat but also muscle tissue. Studies suggest that a considerable amount of weight lost on GLP-1 medications may come from fat-free mass, including muscle.
This matters because muscle is extremely important for long-term health. Muscle helps people stay strong, mobile, independent, and physically active as they age.
Too much muscle loss can lead to weakness, lower physical function, balance problems, and a condition known as sarcopenia, which is age-related muscle decline.
The researchers say exercise, especially resistance training such as lifting weights or strength exercises, may help reduce muscle loss during weight reduction.
Another issue is that many patients eventually stop taking GLP-1 medications.
Research shows that up to 60 percent of patients discontinue the drugs within a year. Cost, side effects, difficulty obtaining prescriptions, and long-term adherence challenges all contribute to this problem.
When the medications are stopped, many people regain a large portion of the lost weight.
The researchers say regular physical activity may help reduce this regain and improve long-term success after medication treatment.
Even though doctors understand the benefits of exercise very well, helping people maintain long-term physical activity remains difficult.
Many individuals face obstacles such as busy schedules, chronic pain, fatigue, joint problems, low motivation, or lack of safe places to exercise.
For some people with obesity, exercise may also feel physically uncomfortable or emotionally discouraging.
Because of this, the researchers argue that doctors need to move beyond giving simple advice like “exercise more.”
Instead, healthcare providers should help patients create realistic activity plans that fit their own lifestyles, physical abilities, and personal preferences.
The article encourages doctors to identify barriers to exercise and help patients find enjoyable forms of movement that feel sustainable.
This could include walking, swimming, dancing, gardening, cycling, stretching, yoga, resistance training, or even small increases in daily movement.
The researchers stress that consistency matters more than perfection. Sustainable movement habits are more likely to succeed than intense exercise programs that patients eventually quit.
The perspective also reflects a larger shift in obesity medicine. Experts increasingly recognize that obesity is not simply caused by lack of willpower or poor choices.
Instead, obesity is now understood as a complicated chronic disease influenced by hormones, metabolism, appetite regulation, genetics, environment, stress, sleep, and lifestyle factors.
GLP-1 medications are changing treatment because they directly target some of the biological systems involved in appetite and weight regulation.
However, the researchers believe medications alone cannot fully replace the broad health benefits of physical activity.
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