Are Anti-Obesity Drugs Enough?
In recent years, anti-obesity drugs have surged in popularity, with brand names like Saxenda, Mounjaro, Zepbound, and Xenical becoming household names. With obesity levels rising globally, affecting over 1 billion people worldwide according to the World Health Organization (WHO), it’s no surprise that many people are turning to these medications as a potential solution. The UK has seen a particularly sharp increase in the prescription of these drugs, with data from the NHS indicating a 65% rise in obesity medication prescriptions over the past five years.
For many, these drugs seem like a quick fix, a magic pill to melt away excess weight without the gruelling effort of lifestyle changes. And while they do offer clinically significant weight loss, the question remains, are they enough? Can a prescription alone truly tackle obesity, or is there more to the story? A recent systematic review with meta-analysis delves into this issue, exploring how combining anti-obesity drugs with exercise training might be the key to sustainable weight loss and better health outcomes.
A research team comprising Bruna Marmett, Igor da Silva, Fabio Lira, and Gilson Dorneles conducted a systematic review and meta-analysis titled: Anti-Obesity Drugs Alone or Combined with Exercise Training in the Management of Obesity (Marmett et al., 2025). Published in the journal Translational Exercise Biomedicine, this study sought to compare the effects of anti-obesity drugs alone versus anti-obesity drugs combined with exercise training. The goal was to determine how these two approaches influenced body weight, body fat, fat-free mass, and cardiorespiratory fitness in obese individuals.
The researchers conducted a systematic review of randomised clinical trials (RCTs), gathering data from four studies with a total of 202 participants. These individuals were all classified as obese (BMI >30 kg/m²) but did not have type 2 diabetes. The anti-obesity drugs assessed included Orlistat (Xenical/Alli), Liraglutide (Saxenda), and Tirzepatide (Mounjaro/Zepbound). Some participants used these medications alone, while others combined them with structured exercise training.
The primary outcomes assessed were changes in body weight, body fat, fat-free mass (muscle retention), and VO2Peak (a measure of cardiorespiratory fitness). The GRADE approach was used to assess the quality of evidence, ensuring robust and reliable conclusions.
The findings were clear but nuanced. While anti-obesity drugs alone do contribute to weight loss, their effects are significantly improved when combined with exercise. Let’s break down the key results:
Weight Loss: More Effective with Exercise
Fat Mass Reduction: Drugs Help, But Exercise Enhances It
Fat-Free Mass (Muscle Retention): Exercise Prevents Muscle Loss
Cardiorespiratory Fitness (VO2Peak): Exercise is Essential
When working with clients using anti-obesity medications, the key takeaway is that exercise is not optional, it’s essential. To best support clients, implement a structured exercise plan that includes both resistance training and aerobic workouts. Resistance training helps preserve lean muscle mass, which is often lost during weight reduction, while aerobic exercise improves cardiovascular health and metabolic efficiency.
Encouraging progressive overload in strength training (e.g., increasing resistance over time) ensures clients maintain strength and functional fitness. For cardiovascular fitness, interval training or steady-state cardio can be tailored based on individual fitness levels.
Also engage in open conversations about realistic expectations regarding weight loss drugs. Providing education on the benefits of exercise beyond weight loss, such as improved mood, energy levels, and long-term weight maintenance, can enhance adherence. Sharing case studies or testimonials from individuals who have successfully combined exercise with medication could further reinforce the importance of an active lifestyle. Here’s how they can help:
While anti-obesity drugs have transformed weight management, they are not a standalone solution. The study findings make it clear that while these medications aid in weight loss, exercise significantly enhances their effects by promoting fat loss, preserving muscle mass, and improving cardiovascular fitness. Without physical activity, individuals may experience muscle loss and limited metabolic improvements, reducing the long-term effectiveness of weight loss medications. The evidence is clear, exercise significantly enhances weight loss, preserves muscle, and improves fitness. The growing reliance on medications like Saxenda, Mounjaro, and Xenical should be met with an emphasis on lifestyle interventions.
This presents an opportunity to guide, educate, and support clients, ensuring they get the most out of their weight loss journey. By integrating structured exercise programs, they can help clients achieve not just weight loss, but long-term health and fitness.
Marmett, B., da Silva, I., Lira, F., & Dorneles, G. (2025). Anti-obesity drugs alone or combined with exercise training in the management of obesity: A systematic review with meta-analysis. Translational Exercise Biomedicine. Click here to review the full research article.
NHS Digital (2024). Statistics on Obesity, Physical Activity and Diet, England 2024. Available here.
Struggling to support clients managing obesity and diabetes? The Level 4 Obesity & Diabetes Management Course at TRAINFITNESS equips you with the specialist knowledge and skills to make a real difference. With over 1 billion people worldwide affected by obesity (WHO), and NHS prescriptions for anti-obesity medications rising by 65% in the last five years, the demand for qualified fitness professionals in this field has never been higher. A recent systematic review found that anti-obesity drugs alone aren’t enough. Combining medication with structured exercise training led to an additional 3.96kg weight loss and helped preserve fat-free mass. With this course, you’ll learn effective exercise programming, lifestyle interventions, and behavioural coaching techniques to guide clients towards long-term health improvements. Take the next step in your career and become a specialist in obesity and diabetes management. Get started today and help your clients achieve sustainable results beyond the scale!
Level 4 Obesity & Diabetes Management Course – Distance Study
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