GLP‑1 medications like semaglutide (Wegovy, Ozempic) and tirzepatide (Zepbound, Mounjaro) are transforming weight loss for many people. These medications work with the body’s hormones to reduce appetite, stabilize blood sugar, and help patients lose a significant amount of weight.
The benefits are life-changing. Many patients see their weight go down, their blood sugar improve, and their blood pressure and cholesterol move in the right direction. However, a recent University of Virginia review highlights something important. While GLP‑1 medications can deliver impressive weight loss, they do not significantly improve heart and lung fitness unless exercise is part of the plan.
At LIWLI, we have always believed that weight loss should go beyond the number on the scale. Real wellness comes from supporting every system in the body, including the heart and lungs.
What GLP‑1 Medications Can Do for You
GLP‑1 receptor agonists work by slowing digestion and sending signals to the brain that help you feel full sooner and stay satisfied longer. This can lead to reduced calorie intake and steady, sustainable weight loss.
These medications also bring important health benefits. Large clinical trials show they can lower fasting blood sugar, improve insulin sensitivity, reduce liver fat, and improve cholesterol levels. Many patients also experience reduced blood pressure and better metabolic health.
They even reduce the risk of major cardiovascular events in certain high-risk patients, independent of weight loss.
While these medications address many risk factors, they do not automatically strengthen the heart and lungs. That is where exercise plays a crucial role.
What the UVA Study Found
The University of Virginia researchers examined how GLP‑1 medications affect heart and lung fitness, also known as cardiorespiratory fitness. The review found that while participants consistently lost weight, their cardiorespiratory fitness, measured through VO₂max, did not improve without exercise.
Cardiorespiratory fitness is the ability of the heart and lungs to deliver oxygen during activity. It is one of the strongest predictors of long‑term health and longevity. This means that even with lower weight, cardiovascular health may not improve unless physical activity is part of the treatment plan.
Why Cardio is Still Essential
Exercise, especially aerobic exercise, provides benefits that medications cannot replace.
Cardio strengthens the heart muscle so it pumps blood more efficiently. It expands lung capacity and improves oxygen delivery throughout the body. It supports healthy circulation and can lower resting heart rate. It also protects lean muscle mass while promoting fat loss.
Even light to moderate cardio activities such as walking, swimming, or cycling can create meaningful improvements in endurance and overall health.
The Risks of Skipping Exercise
Patients who use GLP‑1 medications without exercise may still lose weight, but they risk losing more muscle than they realize. At LIWLI, we measure if your weight loss is coming from muscle, fat, or water. Most of our patients end up losing less than 10% lean muscle mass while on one of our programs. Research shows that 25 to 40 percent of the weight lost on these medications can be lean mass if exercise and a high-protein diet are not implemented while the patient is actively losing weight.
Muscle is essential for maintaining a healthy metabolism, supporting joint health, and preventing injury.
Without regular activity:
- Metabolism may slow as muscle mass decreases
- Stamina may remain low, even after weight loss
- Cholesterol and blood sugar improvements may plateau
- The risk of regaining weight can increase after stopping the medication
Exercise helps preserve lean muscle and maintain the progress made with GLP‑1 therapy.
How LIWLI Combines Medication and Movement
At LIWLI, our programs are designed to pair GLP‑1 therapy with medically guided exercise and diet for the best results. We know that a combined approach improves not only weight loss but also overall fitness and health.
Our process often includes:
- A thorough health assessment to understand your needs and capabilities
- A gradual introduction to movement that matches your current ability
- Customized cardio programs to improve endurance safely and steadily
- Strength training to protect lean muscle and support a healthy metabolism
- Ongoing monitoring to adjust your plan as your fitness improves
Whether you are starting from a low activity level or already have an exercise routine, we work with you to create a plan that fits your lifestyle.
Making Exercise Comfortable and Achievable
For many patients, the idea of starting a workout program feels overwhelming. Pain, fatigue, or past experiences may create hesitation. That is why LIWLI focuses on making exercise approachable.
We start with gentle, achievable activities that build confidence. Over time, as endurance grows, patients often find themselves capable of more than they imagined. The emphasis is always on progress that feels sustainable.
Practical Cardio Tips for Beginners on GLP‑1 Therapy
Starting cardio does not have to mean joining a gym or running long distances. The key is consistency and choosing activities you enjoy.
Some practical ways to begin:
- Start with 10 to 15 minutes of walking a few times per week and build up gradually
- Try low‑impact activities like swimming, stationary biking, or water aerobics
- Break exercise into shorter sessions throughout the day if needed
- Pair movement with something enjoyable, like listening to music or walking with a friend
- Focus on steady progress rather than speed or intensity in the beginning
Your heart and lungs will respond to regular, consistent activity, even at a comfortable pace.
How to Maintain Cardio Gains Long Term
Consistency is the secret to lasting results. Once cardio becomes a regular part of your week, the next step is to maintain it in a way that feels natural and sustainable.
Some strategies that work well:
- Keep your activities varied to prevent boredom
- Set realistic goals that can be maintained even on busy weeks
- Celebrate small milestones, like walking a longer distance or climbing stairs without fatigue
- Schedule exercise like any other important appointment
- Work with your LIWLI provider to adjust your program as your fitness improves
Maintaining cardiovascular fitness ensures that the benefits of GLP‑1 therapy last long beyond the treatment period.
Signs Your Fitness is Improving
At LIWLI, we help patients look beyond the scale to see the bigger picture of their progress. Improvements in cardiorespiratory fitness can show up in many ways, such as:
- Climbing stairs without getting out of breath
- Walking longer distances with less fatigue
- Experiencing better sleep and higher energy levels
- Noticing a lower resting heart rate
- Recovering faster after physical activity
These signs indicate that your heart and lungs are growing stronger.
Looking at the Whole Picture of Health
Weight loss injections are an important tool, but they are just one part of a comprehensive program. At LIWLI, we combine medication, nutrition guidance, exercise, and lifestyle coaching to create lasting health changes.
This approach helps ensure that weight loss is supported by improved strength, endurance, and overall well‑being. Exercise is a vital part of this plan because it enhances every other aspect of your health journey.
Moving Forward With Support
GLP‑1 medications make weight loss more achievable and can lead to life‑changing improvements in health. However, research shows that medication alone is not enough to improve heart and lung function.
Adding consistent cardio to your plan helps ensure your progress is not just about the scale but about building strength, endurance, and long‑term wellness.
At LIWLI, we are here to guide you through each step. With a program built around your needs, including medication, nutrition support, and an exercise plan you can stick to, you have the tools to succeed safely and sustainably.
Your journey is about more than losing weight. It is about building a stronger, healthier future.