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MedStar Health Research Institute experts joined with the American Heart Association to issue a collaborative scientific statement about the important role of exercise in weight loss, weight management, and overall heart health.
One of the most common questions I hear from patients taking GLP-1 medications such as Wegovy, Mounjaro, Zepbound, Ozempic or others is: “If the medicine is working, do I still need to exercise?”
The answer is a resounding yes.
These medications can be powerful tools for weight loss and cardiovascular risk reduction, but they're most effective when combined with physical activity and healthy eating habits.
I talk with patients about glucagon-like peptide-1 receptor agonist (GLP-1 RA) medications all the time, and these drugs are getting a tremendous amount of media attention. That’s because medicines like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound) can offer exciting treatment possibilities for many people who have struggled on their weight loss journey. They can also have real cardiovascular benefits. But, they can’t do it all.
As Director of Preventive Cardiology, I talk with my patients about the fact that no matter how you’re working to lose weight, physical activity is essential for your heart health. One of the biggest misconceptions I hear is that exercise becomes less important once someone starts a GLP-1 medication. In reality, that's often when exercise becomes even more important.
Recently, I collaborated with fellow researchers on behalf of the American Heart Association to highlight the role of physical activity in treating obesity and improving cardiovascular health. We agree that when diet and exercise are used to treat obesity alongside medical options, patients can support healthier hearts, weights, and lifestyles at the same time.
Obesity is considered a chronic disease that increases the risk of serious health conditions including diabetes and insulin resistance, heart disease, high blood pressure (hypertension), high cholesterol, and stroke. That's one reason GLP-1 medications have attracted so much attention. These drugs can help people lose weight and improve several important cardiovascular risk factors.
But weight loss is only part of the equation. To get the greatest benefit from treatment and maintain long-term health, patients also need regular physical activity and healthy eating habits. Even when the number on the scale doesn’t go down, being physically active still has big benefits for your heart. Activity can improve your blood pressure, insulin sensitivity, and cardiovascular fitness, no matter what the scale says.
GLP-1 medications support weight loss and reduce the risk of cardiovascular disease, but these drugs aren’t magic pills—or shots—that work alone as long-term treatments for obesity. GLP-1 drugs are a bit like a turbocharger in a car. They can give your health goals a powerful boost, but exercise and nutrition are the engine and steering wheel that keep you on the road.
Could you be losing muscle along with weight?
Weight loss doesn’t only reduce fat. It can also reduce muscle, which can affect your strength, balance, and physical function. Studies suggest that as much as one-third of the weight lost on GLP-1 medications may come from lean muscle mass. That's one reason exercise remains so important, even when the medication is working exactly as intended.
Regular exercise, especially strength training, can help preserve muscle, maintain physical function, and support long-term success. Plus, it can provide a safeguard to keep you strong and your weight down if your medication dose changes or stops in the future.
Like any other chronic disease, obesity is a health condition that’s best managed in partnership with your doctor. Working together, you can build a comprehensive medical plan that’s tailored to your unique health needs.
For example, some patients with type 2 diabetes, high blood pressure, or sleep apnea might benefit from bariatric surgery. Other patients might find success with GLP-1 medicines. But no matter which medical weight loss treatment your doctor recommends, diet and exercise should be part of the plan for successful long-term weight management, maintaining weight loss and wellbeing, and better overall health.
Why diet and exercise still matter on GLP-1 medications.
GLP-1 medications work best when they're part of a larger plan that includes healthy eating and regular physical activity. That's because long-term weight management depends on habits that support heart health, not just the number on the scale.
When it comes to heart-smart eating, I typically recommend these options for my patients:
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A plant-based diet
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Dietary Approaches to Stop Hypertension (DASH), a low-sodium diet that boosts magnesium and potassium
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Mediterranean diet, which includes lean meats, fruits, and vegetables
Every patient has different health needs, so the best choice often depends on your unique health and underlying conditions such as high blood pressure or diabetes. Speak with your doctor about the option that’s right for you.
Following an exercise plan will be another essential part of losing weight, keeping it off, and helping prevent cardiovascular disease. The Centers for Disease Control and Prevention recommends at least 150 minutes of moderate activity, or 75 minutes of intense activity, in the span of one week. Two days of muscle-strengthening exercise are also recommended each week.
You can break these targets into smaller time increments. Try doing a little each day all week, or you can hit your weekly goal in just a few days. It’s important to commit to an exercise plan you can stick with. Find something you like to do – riding a bicycle, swimming, walking in the park with a friend, or playing pickleball.
Just like a diet regimen, a beneficial exercise routine depends on the patient. For example, a patient living with arthritis may not be able to enjoy a long walk. In this case, water aerobics is an option that’s gentle on joints. A stationary bike could be helpful for patients who struggle with balance. Your doctor can make exercise recommendations with your specific health in mind.
What are medical weight loss options?
A healthy diet and regular exercise alone aren’t always enough to help everyone lose a meaningful amount of weight. This is when your doctor may explore medical weight loss tools to supplement the heart-healthy work of diet and physical activity.
In addition to weight loss benefits, GLP-1 medications can help prevent cardiovascular conditions for some patients by lowering:
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Blood sugar (A1C level)
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Blood pressure
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Cholesterol
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Inflammation
The Food and Drug Administration (FDA) approved GLP-1 medications as a helpful weight loss tool when combined with diet and exercise—it’s important to keep that in mind.
GLP-1 medications may not be right for everyone; your doctor can help you decide what’s best for your overall health.
For some patients, medical weight loss may also include bariatric surgery or other treatments. Your doctor can help you decide whether you’re a good candidate for bariatric surgery. No matter which option your doctor recommends, lifestyle changes including healthy eating and regular physical activity are an important part of long-term success.
Related: Read “More Than a Number: Bariatric Surgery, GLP-1 Medications and Tools to Treat Obesity."
The heart of healthy weight loss is a healthy lifestyle.
GLP-1 medications are changing the way we treat obesity and cardiovascular risk, and that's exciting for patients and physicians alike. But lasting success requires more than a prescription. A heart-healthy diet, regular physical activity, and a plan tailored to your individual needs remain the foundation of long-term health.
Talk with your doctor about creating a weight management plan tailored to your health needs. The patients who have the greatest long-term success are those who combine medication with healthy eating, regular physical activity, and habits they can maintain for life.
