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For many people, exercise is a weight-loss tool, with their motivation to work out directly in proportion to their motivation to lose unwanted pounds. But with the popularity, efficacy and availability of the latest weight-loss drugs, lifestyle interventions like exercise have taken a back seat to pharmaceutical solutions that offer better results with a lot less sweat.

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Prior to the recent upsurge in the use of anti-obesity medications, overweight people were largely counselled to move more and eat less. But the results were disappointing.

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Neither diet nor exercise results in significant weight loss, especially over the long term. Even when combined, the results of a lower-calorie diet and regular exercise are modest when success is quantified by the numbers on a scale. But health-care professionals aren’t as concerned about how much a person weighs as they are about the impact excess weight has on health. Overweight people have an increased risk of cardiovascular disease, high blood pressure, stroke, osteoarthritis, Type 2 diabetes, sleep apnea and several types of cancer.

There’s plenty of evidence confirming that the numbers on the scale don’t need to move much for those risk factors to decrease. Modest weight loss of five to 10 per cent of body weight has proven to reduce the threat of almost all chronic health conditions related to obesity.

Yet as welcome as a boost in health is, for most people struggling with their weight the real measure of success is saying goodbye to XXL — which is why antiobesity drugs have become so popular. But before exercise becomes a forgotten tool in the journey to weight loss, public health experts offer a reminder that there’s still plenty of value in working up a sweat.

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“Low cardiorespiratory fitness is a powerful risk factor for cardiovascular disease and all-cause mortality and higher levels of cardiorespiratory fitness are associated with other health benefits across the life span that are independent or additive to the effects of lower body weight, lower adiposity or weight loss,” said John Jakicic, from the University of the Kansas Medical Centre, and lead author in a recent commentary in the journal Obesity.

There’s no denying that this new class of obesity drugs also has a powerful impact on heart health. A new study published in the New England Journal of Medicine reported a 20-per-cent decrease in the risk of stroke and heart attack among overweight individuals with pre-existing cardiovascular disease who were taking semaglutide — the newest drug used to treat diabetes and obesity.

Stuart Phillips, a professor and director of the McMaster (University) Centre for Nutrition, Exercise and Health Research, points out that poor aerobic fitness is an independent risk factor for cardiovascular disease, which means the health benefits obtained from exercise supplement those obtained from weight loss and weight loss drugs.

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“Simply focusing only on lost weight undermines the numerous health advantages of exercise, including better mental health, the composition of lost weight and, importantly, improved fitness,” said Phillips in commentary published in the British Journal of Sports Medicine.

Weight loss doesn’t just get rid of unwanted fat. Valuable muscle mass is also lost. Combine a lack of fitness with less muscle and the fatigue associated with low-calorie diets and the chores of everyday life feel challenging despite the lost weight. And with less energy, stamina and strength, it’s harder to enjoy the fun things in life, like activities with family and friends.

It’s not just the experts rallying behind the benefits of physical activity. Studies of individuals using prescribed weight-loss drugs claimed exercise made a difference when it came to how they perceived their overall health and wellness. More of the exercisers felt confident in their health than those who never work out. They also reported better emotional well-being than the diet-only group.

As for what types of exercise should be prioritized as an adjunct to weight-loss drugs, whatever activity raises your heart rate such that you can hear yourself breathe and requires a sustained effort will do the trick. And because your primary goal is health, 150 minutes of aerobic activity accumulated over the course of a week is a great place to start.

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And don’t forget weight training. A loss of muscle mass is inevitable when you drop a significant amount of weight, but lifting weights can ameliorate some of that loss as well as enhance the quality of muscle that remains. A twice-a-week routine that focuses on all the major muscle groups will help retain a functional measure of strength.

When it comes to how hard and how often to exercise, consistency is more important than intensity. A couple of dumbbells and/or kettlebells should offer enough challenge, but you might want to enlist the services of a personal trainer to help design an effective and efficient routine. And for days when time is tight and/or motivation is low, even a short bout of exercise can provide a much-needed energy boost. Severely cutting back on calories can lead to chronic fatigue, so as counterintuitive as it may seem, exercise remains one of the best ways to reset your mood and energy levels while stealthy improving health.

“Beyond weight loss, in addition to weight loss, and even in the absence of weight loss, it is abundantly clear that being physically active is associated with a myriad of health benefits, some of which are simply not achieved through diet-induced weight loss,” Phillips said.

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