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June 1, 2026Circulation
Role of Physical Activity in Obesity Treatment and Cardiometabolic Health: A Scientific Statement From the American Heart Association
Why the study?
Physical activity is a key component of comprehensive obesity treatment to reduce obesity and cardiovascular disease risk, warranting a summary of its role alongside lifestyle, pharmacological, and surgical strategies.
Does physical activity improve weight loss, weight loss maintenance, and cardiometabolic health in adults with overweight or obesity?
Key Points
- Physical activity improves cardiometabolic health independently of weight loss, but exercise alone rarely produces meaningful reductions in body weight.
- Aerobic exercise reduces systolic blood pressure by 3.0 mm Hg and improves insulin resistance, yet fewer than 15% of participants achieve 5% weight loss.
- Scientific statement synthesizes clinical trials and guidelines, indicating that targeted physical activity counseling enhances long-term care strategies.
Structured PICO
Does physical activity improve weight loss, weight loss maintenance, and cardiometabolic health in adults with overweight or obesity?
P
Population
Adults with overweight or obesity undergoing comprehensive weight management and cardiometabolic risk reduction.
I
Intervention
Physical activity and exercise programs (aerobic, resistance, or combined), independently or as an adjunct to diet, obesity medications (e.g., GLP-1 receptor agonists), or bariatric surgery
O
Outcome
Weight loss, weight loss maintenance, and cardiometabolic health (blood pressure, insulin resistance, dyslipidemia, cardiorespiratory fitness)
Physical activity is a critical component of comprehensive obesity treatment that independently improves cardiometabolic risk profiles and augments weight loss and lean mass preservation when combined with dietary, pharmacological, or surgical interventions.
Limitations
- Lack of clear dose-response data from prospective trials for weight loss maintenance.
- Limited data on whether physical activity can attenuate cardiometabolic risk parameter increases during weight regain.
- Insufficient data evaluating specific physical activity doses or modalities in combination with GLP-1RA therapy.
- Lack of clear dose-response data from prospective trials on weight loss maintenance
- Limited data evaluating physical activity in combination with modern obesity medications (e.g., GLP-1 receptor agonists)
- Heterogeneity across existing studies regarding physical activity interventions in pre- and post-bariatric surgery populations
Discussion
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Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“We wanted to put a paper together that summarizes the evidence of how physical activity affects cardiovascular disease and how it may be useful in cases of surgery and when people are taking GLP-1s. The statement really does two things overall. First, we're summarizing what the evidence tells us about the role of physical activity and exercise across the full spectrum of obesity treatment, and it's also giving clinicians and providers some practical guidance on how to help support their patients in becoming and remaining physically active.”
“Physical activity has really important cardiovascular and metabolic health benefits that are independent of weight loss. So even for patients who may not be losing weight or may not be meeting their weight loss goals, exercise really matters for a plethora of health benefits ranging from helping with blood pressure control, metabolic and glucose control, improving insulin resistance and overall quality of life.”
“We also want to be realistic with clinicians and providers about what physical activity can and can't do for weight loss. On its own, exercise alone actually leads to pretty minimal weight loss, only about up to 1 to 3% total body weight loss. However, when it's combined with either reduced caloric intake or with some of these newer medications or surgery, it can meaningfully enhance our outcomes.”
Implication
Incorporate physical activity into obesity care for cardiometabolic gains independent of weight; extends evidence for its adjunctive role with diet, medications, or surgery.
Abstract
Weight loss and weight loss maintenance are prominent topics of discussion for clinicians and health professionals involved in treatment to reduce obesity and the risk of cardiovascular disease. Because physical activity is a key component of comprehensive obesity treatment, this scientific statement summarizes the role of physical activity in promoting weight loss, weight loss maintenance, and cardiometabolic health, complementing lifestyle, pharmacological, and surgical-based weight loss intervention strategies. Independently of weight loss, physical activity and exercise programs improve major cardiometabolic risk factors, including hypertension, insulin resistance, and dyslipidemia, which are highly prevalent in patients with overweight or obesity. As a single treatment modality, physical activity and exercise programs are unlikely to result in clinically meaningful weight loss (ie, at least 5% loss of initial body weight) unless aerobic physical activity levels are exceptionally high. When combined with diet-induced negative energy balance, obesity medication, or surgical treatment, increased physical activity can augment total weight loss and improve cardiometabolic outcomes. Because clinicians and health professionals play a pivotal role in fostering and sustaining patients' health goals, this scientific statement also provides an overview of evidence-based strategies for targeted weight loss counseling and for leveraging digital technology, particularly to engage patients and achieve realistic physical activity goals.
Cite This Study
Swift et al. (2026) conducted a review in Obesity and overweight. Physical activity and exercise vs. No physical activity or diet/medication alone was evaluated. Physical activity improves cardiometabolic risk factors independently of weight loss and significantly augments weight loss when combined with dietary energy restriction, obesity medications, or bariatric surgery.