Exercise Outperforms Medication for Vascular Health
Regular exercise significantly improves vascular health and reduces systemic inflammation in individuals with severe obesity, even when weight-loss medication is also used, according to a study published in Nature Metabolism. While liraglutide is effective for weight maintenance, the findings suggest it does not replicate the specific cardiovascular benefits gained through physical activity.
Tracking Arterial Thickness in Clinical Trials
Researchers at the University of Copenhagen monitored 130 individuals with severe obesity for one year following an initial low-calorie diet phase that resulted in an average weight loss of 13.7 kg (30.2 lbs). The participants were divided into four groups: exercise only, liraglutide treatment only, a combination of exercise and medication, and a placebo group.
After one year, the study found that participants who incorporated exercise—regardless of whether they also took liraglutide—showed a 6–7% reduction in carotid artery wall thickness. This measurement is a clinical marker for cardiovascular risk; thicker artery walls are associated with higher risks of atherosclerosis, blood clots, and stroke. In contrast, the groups that relied on liraglutide alone or the placebo showed no significant improvement in vascular wall thickness.
Reducing Systemic Inflammation
Chronic inflammation is a known driver of cardiovascular disease. The study observed that physically active participants experienced a decrease in several markers of systemic inflammation. Signe Torekov, a professor at the University of Copenhagen’s biomedical sciences department, noted that while medication is an effective tool for sustaining weight loss, it does not provide the same vascular health benefits as exercise.
Low-Intensity Training Yields Results
The researchers emphasized that the positive outcomes did not require intense training. Participants engaged in approximately two and a half hours of exercise per week, primarily consisting of spinning and circuit training. These activity levels were verified objectively through the use of heart-rate monitors.
A Non-Negotiable Component of Care
The participants in the study were in their mid-40s and had not yet developed clinical heart disease or diabetes. According to Rasmus Sandsdal, a medical doctor and PhD student at the University of Copenhagen and the study’s first author, the results suggest that even modest increases in physical activity can address key cardiovascular risk factors in this population.
The study specifically evaluated liraglutide, an earlier-generation GLP-1 weight-loss medication. While the researchers noted that their findings cannot be directly extrapolated to newer weight-loss medications like semaglutide, they highlighted that liraglutide successfully maintained weight loss at a level comparable to newer drugs. The research underscores that as the use of weight-loss medication grows, physical activity remains a fundamental component of treatment for managing the long-term health of the cardiovascular system.