Beyond weight loss: the value of physical activity and exercise for improving cardiometabolic risk factors in individuals with overweight and obesity

The global prevalence of overweight and obesity has increased markedly over recent decades. In clinical obesity care, and in the management of other chronic conditions, the role of physical exercise has largely been evaluated in the context of weight loss. Yet, while it only leads to modest changes in body weight, structured exercise provides extensive health benefits beyond weight loss. A multimodal exercise approach, progressing from reducing sedentary time to incorporating aerobic and resistance training, can provide an effective strategy to improve cardiovascular and metabolic health and body composition. Moreover, integrating structured exercise into surgical and pharmacological obesity care trajectories may support long-term, post-treatment health improvements. This narrative review synthesizes evidence on the effect of exercise on cardiometabolic health and body composition in individuals with overweight and obesity. Furthermore, we also examine the role of structured exercise in supporting cardiometabolic health and preserving skeletal muscle mass during surgical and pharmacological obesity treatment.