Physical Activity Key to Obesity Treatment and Heart Health Despite New Weight-Loss Therapies: AHA Scientific Statement
USA: Physical activity remains a cornerstone of obesity treatment and cardiometabolic health, providing benefits that extend beyond weight loss alone. According to a new scientific statement from the American Heart Association (AHA), regular physical activity improves cardiovascular risk factors, enhances weight-loss outcomes when combined with other treatments, and plays a critical role in maintaining long-term weight reduction. The statement, published in Circulation, was authored by Damon L. Swift and colleagues.
Obesity continues to be a major public health challenge worldwide and is closely linked to cardiovascular disease, type 2 diabetes, hypertension, and dyslipidemia. While newer anti-obesity medications and bariatric surgery have expanded treatment options, experts emphasize that physical activity remains a fundamental component of comprehensive obesity management.
The AHA statement reviews current evidence on the role of physical activity in weight loss, weight-loss maintenance, and cardiometabolic health. The authors note that exercise alone generally produces only modest weight loss and is unlikely to result in a clinically meaningful reduction of 5% or more of initial body weight unless performed at very high levels. However, when combined with dietary interventions, obesity medications, or bariatric surgery, physical activity can significantly enhance weight-loss outcomes and improve overall health.
Key Takeaways
- Physical activity improves major cardiometabolic risk factors, including blood pressure, insulin resistance, and abnormal lipid levels, even in the absence of significant weight loss.
- Diet-induced calorie reduction remains the primary driver of weight loss, accounting for the majority of weight reduction achieved during lifestyle interventions.
- Aerobic exercise can enhance weight loss when combined with dietary changes, with greater benefits generally observed at higher activity levels.
- Exercise alone often produces variable weight-loss results and typically does not lead to substantial weight reduction unless performed in large volumes.
- Resistance training helps preserve lean muscle mass during weight loss while improving muscle strength and physical function.
- Physical activity is an important adjunct to obesity medications and bariatric surgery and may improve both weight-loss and cardiometabolic outcomes.
- Following weight loss, regular aerobic exercise can help reduce the likelihood of weight regain and support long-term weight maintenance.
- Patients who have lost weight are encouraged to engage in at least 150 minutes of physical activity per week, with higher levels potentially providing additional benefits.
- After bariatric surgery, combining 150–300 minutes of aerobic activity per week with resistance training two to three times weekly may further improve body composition, fitness, and weight maintenance.
- Clinicians should use personalized counseling approaches, including SMART goal setting and evidence-based behavioral strategies, to promote long-term physical activity engagement.
- Digital health technologies and self-monitoring tools can help patients stay active and maintain healthy lifestyle behaviors.
The statement also highlights the importance of counseling strategies that encourage sustainable behavior change. Experts recommend that healthcare professionals work collaboratively with patients to establish realistic and measurable physical activity goals. Structured approaches such as the SMART framework—Specific, Measurable, Achievable, Relevant, and Time-bound—and the 5A model (assess, advise, agree, assist, arrange) may improve long-term adherence.
Importantly, the benefits of physical activity extend far beyond weight control. Regular exercise improves cardiorespiratory fitness, body composition, metabolic health, and quality of life while reducing cardiovascular disease risk. These effects are particularly relevant for individuals with obesity, who often experience multiple cardiometabolic risk factors.
The authors conclude that physical activity should remain an integral component of obesity treatment across lifestyle, pharmacological, and surgical interventions. They stress that multidisciplinary care involving physicians, exercise specialists, dietitians, and other healthcare professionals is essential for achieving and sustaining weight-loss goals. Expanding access to effective, affordable, and culturally appropriate physical activity programs may help address rising obesity rates and reduce the burden of obesity-related cardiovascular disease across diverse populations.
Reference:
https://doi.org/10.1161/CIR.0000000000001441
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