Top Things to Know: The Role of Physical Activity in Obesity Treatment and Cardiometabolic Health
Updated: June 01, 2026
Prepared by Leanna Ross, PhD, Duke University and Damon Swift, PhD, University of Virginia
- Obesity affects 42% of adults in the United States and is strongly associated with cardiovascular disease risk factors, including high blood pressure, abnormal cholesterol levels, and insulin resistance, making effective obesity treatment a critical public health priority.
- Physical activity improves major cardiovascular risk factors, including blood pressure, insulin resistance, and cholesterol, independent of weight loss, highlighting the broad cardiometabolic value of physical activity beyond the number on the scale.
- As a stand-alone strategy, physical activity alone is unlikely to produce clinically meaningful weight loss of at least 5% of body weight unless exercise levels are high (e.g., 225-420 min/week of physical activity). However, modest weight loss of around 3%-5% through increased physical activity alone is more achievable, with greater weight loss occurring as activity levels increase.
- When combined with reduced calorie intake, physical activity augments total weight loss, though the dietary component drives most of the weight loss response.
- Loss of lean mass is a potential concern during weight loss, particularly for older adults or those with low lean mass to begin with; resistance training and adequate protein intake may help preserve lean mass during weight loss, though research findings are mixed.
- Higher levels of physical activity are associated with better long-term weight loss maintenance, and even moderate activity levels combined with behavioral support can help prevent weight regain, though the optimal amount of activity needed remains an active area of research.
- GLP-1-based therapies such as semaglutide and tirzepatide represent a major advance in obesity treatment; while data on the combined effects of these medications and exercise are still emerging, patients on these medications are still expected to benefit from meeting general physical activity recommendations.
- Physical activity after bariatric surgery is associated with better weight loss and weight loss maintenance, as well as improvements in fitness and strength, highlighting the importance of incorporating physical activity programs into postsurgical care.
- Clinicians play a pivotal role in supporting patients' physical activity goals; evidence-based approaches such as the 5A model (assess, advise, agree, assist, arrange) can guide these conversations, and a "some is better than none" message may be especially effective for patients who are currently physically inactive.
- Digital tools – including smartphone apps and wearables – offer promising ways to support physical activity and weight management, with the potential to reach a broader range of patients.
Citation
Swift DL, Ross LM, Laddu DR, Conroy MB, German CA, Evangelista LS, Marvel FA, Jerome GJ; 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. Role of physical activity in obesity treatment and cardiometabolic health: a scientific statement from the American Heart Association. Circulation. Published online June 1, 2026. doi: 10.1161/CIR.0000000000001441