Regular Exercise Outperforms GLP-1 Medication in Reducing Heart Attack and Stroke Risks Post-Weight Loss

Maintaining weight loss through consistent physical activity appears to be more effective in reducing the risk of atherosclerosis— a primary cause of heart attacks and strokes— than relying solely on GLP-1 receptor agonist drugs like liraglutide. A recent study presented at the 2025 European Association for the Study of Diabetes (EASD) Annual Meeting highlights that regular exercise significantly diminishes inflammatory biomarkers and improves vascular health markers in adults who have lost weight.

The research, conducted by scientists from the University of Copenhagen, involved 215 adults with obesity (BMI 32–43 kg/m²) who had successfully reduced their weight after an eight-week low-calorie diet of 800 kcal/day. Following weight loss, participants were assigned to one of four strategies for one year: moderate-to-vigorous exercise (150 min/week), liraglutide treatment (3 mg daily), both combined, or a placebo.

Throughout the study, researchers measured inflammatory markers such as interleukin-6 (IL-6) and interferon-γ (IFN-γ), along with markers of endothelial function including ICAM-1, VCAM-1, and tissue plasminogen activator (tPA). Ultrasound assessments of the carotid artery also gauged changes in arterial wall thickness.

Results showed that those engaging in regular exercise, with or without liraglutide, experienced lower levels of inflammation— with IL-6 levels reduced by 21% and IFN-γ by 27%. Additionally, biomarkers indicative of endothelial health improved, with reductions in VCAM-1, ICAM-1, and tPA, and a slight decrease in carotid artery thickness. Interestingly, liraglutide alone did not significantly influence these markers compared to non-treated groups.

Lead researcher Dr. Rasmus Sandsdal emphasized that exercise exerts a protective effect against atherosclerosis independent of weight maintenance. "Since both exercise and GLP-1RA treatment helped sustain weight loss, it is clear that physical activity plays a crucial role in lowering cardiovascular risks beyond mere weight management," he stated. Excess weight and obesity contribute to systemic inflammation and endothelial dysfunction, setting the stage for vascular disease.

The study underscores the importance of regular physical activity for long-term cardiovascular health, particularly for individuals who have successfully lost weight. Exercise enhances body composition, boosts cardiopulmonary fitness, and supports vascular integrity, all contributing to decreased risk of cardiovascular events.

While pharmacological options like GLP-1RAs are beneficial for weight loss and managing obesity-related risks, this research indicates that exercise provides additional vascular benefits. The findings advocate for integrating structured physical activity into obesity treatment programs for sustained heart health benefits.

Despite some limitations, including the small sample size and the challenge of maintaining adherence outside a controlled trial setting, the study opens avenues for future research. Investigating the combined effects of exercise and newer GLP-1RAs over longer durations could further clarify optimal strategies for cardiovascular risk reduction.

In summary, maintaining a physically active lifestyle after weight loss can significantly reduce inflammation and improve vascular health, thereby lowering the risk of life-threatening cardiovascular events. Healthcare providers should encourage ongoing exercise as a vital component of long-term obesity management and heart disease prevention.

Source: https://medicalxpress.com/news/2025-09-weight-loss-regular-glp-drug.html