Severe obesity is becoming more common around the world and greatly increases the risk of heart disease, stroke, type 2 diabetes, and many other health problems.
In recent years, weight-loss medicines have become increasingly popular because they can help people lose weight and keep it off. However, doctors have continued to ask an important question. Does losing weight with medicine provide all the same health benefits as regular exercise, or does physical activity still play a special role?
A new study from the University of Copenhagen suggests that exercise remains essential, even for people taking weight-loss medication. The researchers found that regular physical activity improved the health of blood vessels and reduced inflammation, benefits that were not seen with medication alone.
The study followed 130 adults with severe obesity. Before the main part of the study began, everyone completed a low-calorie diet and lost an average of 13.7 kilograms, or about 30 pounds. The researchers then divided the participants into four groups.
One group followed an exercise program. Another took the weight-loss medicine liraglutide. A third group combined exercise with liraglutide. The final group received a placebo, which contained no active medicine.
The scientists followed the participants for one year. At the end of the study, they carefully examined their blood vessels and measured several signs of heart health.
One important test measured the thickness of the wall of the carotid artery, a major blood vessel in the neck that supplies blood to the brain. A thicker artery wall is linked with a higher risk of atherosclerosis, blood clots, heart attacks, and strokes.
People who exercised reduced the thickness of this artery wall by about 6% to 7%. In contrast, people who relied only on liraglutide or received the placebo showed no meaningful improvement in this important measure.
The researchers also measured inflammation in the body. Long-term inflammation can slowly damage blood vessels and is known to increase the risk of cardiovascular disease. The exercise groups had lower levels of several inflammatory markers, showing that regular physical activity helped calm harmful inflammation.
The greatest overall benefits were seen in people who combined exercise with weight-loss medication. They maintained their weight loss, lost even more weight, and also improved several measures of blood vessel function.
This suggests that medicine and exercise can work well together, but exercise provides unique health benefits that medicine alone cannot replace.
An encouraging finding was that participants did not need extreme workouts. On average, they exercised for only about two and a half hours each week. Most of their activity included spinning classes and circuit training.
Heart-rate monitors confirmed that participants completed the recommended amount of exercise. This shows that even a modest amount of regular physical activity can make a meaningful difference.
The researchers noted that the participants were generally in their mid-40s and had severe obesity but had not yet developed diabetes or heart disease. This means the improvements were seen before serious illness appeared, highlighting the importance of early action to protect long-term health.
The medicine used in this study was liraglutide, an older type of GLP-1 weight-loss drug. The researchers explained that the findings cannot automatically be applied to newer medicines such as semaglutide, which is sold under brand names including Wegovy.
However, the study clearly showed that while medication helped people maintain weight loss, exercise delivered additional benefits for the heart and blood vessels.
The researchers believe these findings carry an important message for both doctors and patients. Weight-loss medicines can be valuable tools, but they should not replace regular physical activity.
Exercise improves the body in ways that go beyond the number shown on the scales. It strengthens the heart, improves blood vessel function, lowers inflammation, and may reduce the risk of future cardiovascular disease.
The study was published in the European Heart Journal.
Overall, this was a well-designed clinical study that compared exercise, medication, their combination, and a placebo after participants had already lost weight. This design makes the findings more reliable than many observational studies.
However, the research examined liraglutide rather than the newest GLP-1 medicines, so additional studies will be needed to determine whether similar results are seen with newer drugs. Even so, the evidence strongly suggests that regular exercise remains a key part of treating severe obesity and protecting long-term heart health.
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Source: University of Copenhagen.
