Circulation
Exercise benefits go beyond the scale in obesity care
Clinical Takeaway: Prescribe physical activity as a treatment for cardiometabolic health—not just weight loss. Encourage at least 150 minutes/week of moderate-intensity aerobic activity plus muscle-strengthening exercise twice weekly, and consider higher activity levels (200–300 minutes/week) to support long-term weight-loss maintenance.
Physical activity remains underused in obesity treatment despite strong evidence that it improves blood pressure, insulin sensitivity, lipids, fitness, and long-term weight maintenance—even when patients don’t achieve substantial weight loss.
A new American Heart Association scientific statement emphasizes that physical activity should be a cornerstone of obesity treatment because its cardiovascular and metabolic benefits extend well beyond changes on the scale. Regular exercise improves blood pressure, insulin resistance, dyslipidemia, and cardiorespiratory fitness in adults with overweight or obesity, independent of weight loss.
“Physical activity delivers powerful heart and metabolic health gains even when the scale doesn’t move,” said statement chair Damon L. Swift, PhD. “Exercise can help you be healthier even if you don’t lose weight.”
The statement notes that exercise alone rarely produces clinically meaningful weight loss (≥5% of body weight) unless aerobic activity reaches very high levels—roughly 225–420 minutes per week. Most weight loss is driven by dietary changes, but adding exercise can enhance weight reduction, help preserve lean muscle mass, improve fitness, and amplify cardiometabolic benefits. Resistance training appears particularly important for maintaining muscle during weight loss, especially in older adults.
For patients using anti-obesity medications such as GLP-1 receptor agonists or undergoing bariatric surgery, physical activity should remain part of comprehensive care. Although evidence is still evolving, exercise may enhance weight-loss outcomes, preserve lean mass, improve fitness, and support long-term maintenance.
The authors also highlight the challenge of sustaining weight loss. Evidence suggests that higher levels of ongoing physical activity—often 200–300 minutes per week of moderate-intensity activity—are associated with better long-term weight-loss maintenance and may help preserve improvements in blood pressure and insulin sensitivity even if some weight regain occurs.
To improve adherence, the statement recommends team-based obesity care using the 5A framework (Assess, Advise, Agree, Assist, Arrange), SMART goal setting, referrals to exercise and behavioral specialists, and the use of digital tools such as wearables and mobile apps to support long-term behavior change.
Source: Swift DL, et al; on behalf the American Heart Association Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Hypertension; and Stroke Council. (2026, June 1). Circulation. Role of Physical Activity in Obesity Treatment and Cardiometabolic Health: A Scientific Statement From the American Heart Association