For people looking to lose weight, more exercise is one of the first lifestyle solutions that comes to mind. But it can be discouraging when the number on the scale doesn’t seem to move much, or not at all.
The good news: Exercise can meaningfully improve health and is crucial for people living with obesity, even if it doesn’t result in weight loss. That’s according to a new scientific statement from the American Heart Association (AHA).
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“If exercise is viewed only as a weight loss tool, people quit when the scale does not move — and that is the wrong conclusion,” says John P. Higgins, MD, a professor and cardiologist at the McGovern Medical School with UTHealth Houston.
“From a cardiology standpoint, a patient may be getting meaningfully healthier before they get lighter. Blood pressure improves. Insulin resistance declines. HDL cholesterol rises. Cardiorespiratory fitness increases. Each of those changes saves lives,” he says.
Clearing Up a Common Misconception About Exercise Resulting in Weight Loss
The new scientific statement addresses the false belief that a modest amount of exercise can lead to major weight reduction.
“The reality is that exercise alone without any dietary changes is unlikely to produce what we call clinically meaningful weight loss, which is at least 5 to 10 percent” of starting body weight, says Damon L. Swift, PhD, the chair of the scientific statement writing group and an associate professor of kinesiology at the University of Virginia in Charlottesville.
“Exercise is extremely important, but we need to be honest about what it does and does not do,” says Vance L. Albaugh, MD, PhD, a bariatric and metabolic surgeon with Metamor, a specialized obesity and diabetes clinic in Baton Rouge, Louisiana. “The message is that exercise matters enormously for health, but we should be realistic about how much activity is usually needed to produce and maintain significant weight loss.”
That said, weight loss without exercise may pose risks, especially to people on GLP-1 medications.
“Patients taking powerful weight loss medications still need physical activity. Otherwise, they may lose not only fat mass, but also a significant amount of muscle, which matters for long-term health and function,” says Dr. Albaugh, who is also a spokesperson for the Obesity Society but was not involved in the AHA statement.
The same message applies to those undergoing weight loss (bariatric) surgery: Those who don’t get adequate exercise risk losing muscle, regaining weight, and experiencing other health issues.
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How Much Should You Exercise for Optimal Heart Health?For adults to keep the heart in top shape, the AHA recommends a minimum of 150 minutes (that’s two and a half hours) of moderate-intensity aerobic activity per week or 75 minutes per week of vigorous aerobic activity.
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Moderate-intensity activities include:
Brisk walking (2.5 miles per hour, or 1 mile every 24 minutes)Water aerobicsDancing (ballroom or social)GardeningDoubles tennisBiking slower than 10 miles per hour
Vigorous-intensity aerobic activities include:
Hiking uphill or with a heavy backpackRunningSwimming lapsVigorous aerobic dancingHeavy yard work such as continuous digging or hoeingTennis (singles)Cycling 10 miles per hour or fasterJumping ropeTo maximize health benefits, aerobic activities should be combined with moderate intensity strength-training two or more days per week. You can strength train with traditional methods like free weight and weight machines, or do body-weight activities like push-ups, rock climbing, and heavy gardening, per Mayo Clinic.
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To Keep Off Significant Weight, You May Need More Weekly Exercise
The AHA statement points to evidence showing that 200 to 300 minutes of exercise per week is tied to weight loss maintenance — an amount that is up to twice as much as that recommended for optimal heart health.
Some people may find it difficult to hit these goals. But Peminda K. Cabandugama, MD, an endocrinologist and obesity medicine specialist at Cleveland Clinic, tells patients not to get discouraged.
“There is an absolute benefit in any exercise,” says Dr. Cabandugama. “The large-scale studies are very clear that none of the current diets work after two years for weight loss unless tied into exercise. The same can be said for patients with other interventions, including weight loss medications or even bariatric surgery.”
Just a Little Movement Can Help Your Health
Even if you aren’t able to get the ideal amount of physical activity, “There is a health benefit to getting off the couch and getting some exercise,” says Dr. Swift. “If you are mostly sedentary and looking to start, the most important thing is simply to start moving more than you are now.”
Swift offers these suggestions to get more activity in your daily life:
Look for smart swaps. Take the stairs instead of the elevator, park farther away, and walk during phone calls instead of sitting.Try exercise snacks. Breaking activity into shorter bouts throughout the day (for example, three 10-minute walks instead of one 30-minute walk) may be more manageable for people with busy schedules but just as beneficial.Pick something you love doing. You’re more likely to stick with an activity if it’s something you enjoy.Work out with a friend. An exercise companion can be motivating.Consider using digital tools. Wearables and apps (like one that count steps) help people stay engaged.