Exercise May Protect Heart Health During Weight Loss: What New Research on Liraglutide Reveals

Introduction: Weight Loss Is Only Part of the Heart Health Story

Losing weight is widely recognized as an important step toward improving health, especially for people living with obesity. However, maintaining weight loss and protecting long-term cardiovascular health can be more complex than simply reducing body weight.

A new study published in Nature Metabolism in 2026 has explored how exercise and the weight-loss medication liraglutide affect blood vessel health and inflammation during weight maintenance. The findings suggest that regular physical activity may play a key role in improving cardiovascular markers, even when weight loss has already occurred.

The research was a secondary analysis of the S-LiTE randomized controlled trial, which examined adults with obesity who first completed a structured low-calorie diet and then followed different weight maintenance strategies for one year.

The study found that exercise, either alone or combined with liraglutide, improved important measures linked with vascular health. Liraglutide alone helped maintain weight loss but did not produce the same improvements in blood vessel health and inflammation markers.

Why Blood Vessel Health Matters After Weight Loss

Obesity is associated with several changes in the body that can increase cardiovascular risk. Excess body fat contributes to chronic inflammation, changes in blood vessel function, and the development of atherosclerosis, a condition where arteries become thicker and less flexible.

One measurement scientists use to evaluate early vascular changes is carotid intima-media thickness, commonly known as cIMT. This test uses ultrasound imaging to measure the thickness of the artery walls in the neck. Higher cIMT levels are associated with increased cardiovascular risk.

Researchers wanted to understand whether exercise, liraglutide, or a combination of both could improve vascular health after people had already achieved weight loss.

How the Study Was Conducted

The study included 130 adults with obesity who did not have diabetes. Participants first completed an eight-week low-calorie diet program, losing an average of approximately 13.7 kilograms.

After weight loss, participants were randomly assigned to one of four groups:

• Placebo with normal activity
• Exercise with placebo medication
• Liraglutide treatment with normal activity
• Exercise combined with liraglutide

The intervention continued for 52 weeks.

The exercise program was designed around physical activity recommendations from the World Health Organization. Participants completed supervised exercise sessions involving vigorous cycling, resistance exercises, and additional individual physical activity.

The liraglutide group received a daily dose of up to 3.0 mg, which is an approved dosage for weight management.

Researchers measured changes in artery thickness, inflammatory markers, and indicators of endothelial function, which describes how well blood vessels work.

Exercise Improved Artery Health During Weight Maintenance

One of the most important findings was that exercise was linked with improvements in carotid artery measurements.

After one year:

• The exercise-only group reduced cIMT by about 7 percent.
• The exercise plus liraglutide group reduced cIMT by about 6 percent.
• The liraglutide-only group did not show a significant improvement.

These results suggest that physical activity may create beneficial changes in blood vessels beyond the effects of weight loss alone.

Although cIMT is considered a marker rather than a direct measure of cardiovascular events, reductions in artery wall thickness are considered a positive sign when evaluating vascular health.

Exercise Reduced Inflammation Markers Linked to Heart Disease

Inflammation plays an important role in cardiovascular disease development. People with obesity often have higher levels of inflammatory molecules that can contribute to blood vessel damage.

The researchers measured several inflammatory markers, including interleukin-6 (IL-6) and interferon-gamma (IFN-γ).

After one year:

• Exercise reduced IL-6 levels compared with placebo.
• Exercise also lowered IFN-γ levels.
• The combination of exercise and liraglutide reduced IL-6 levels.
• Liraglutide alone did not significantly improve these inflammatory markers.

These findings indicate that exercise may have anti-inflammatory effects that support cardiovascular protection.

Combining Exercise With Liraglutide May Provide Additional Benefits

While liraglutide helped participants maintain weight loss, the medication alone did not significantly improve the vascular measurements examined in this study.

However, the combination of exercise and liraglutide improved several endothelial function markers, including:

• Soluble intercellular adhesion molecule-1 (sICAM-1)
• Soluble vascular adhesion molecule-1 (sVCAM-1)
• Tissue plasminogen activator (tPA)

These markers are associated with blood vessel health and the processes involved in cardiovascular disease development.

The results suggest that medication-based weight management may be more effective for cardiovascular health when combined with regular physical activity.

What This Means for People Managing Obesity

The study highlights an important message: weight loss is an important goal, but maintaining an active lifestyle may provide additional protection for the heart and blood vessels.

Modern weight management increasingly includes medications such as GLP-1 receptor agonists, including liraglutide. These treatments can support weight reduction and maintenance, but this research suggests they should not replace exercise.

Regular physical activity may help by:

• Improving artery structure
• Reducing chronic inflammation
• Supporting healthier blood vessel function
• Helping maintain long-term weight control

Exercise remains a powerful tool because it affects many biological systems at the same time.

Limitations of the Research

Although the findings are promising, some limitations should be considered.

The study focused on adults with obesity who had already achieved weight loss and did not have diabetes or established cardiovascular disease. Therefore, the results may not apply to every population.

Additionally, cIMT is a measurement used to estimate vascular risk rather than a direct prediction of future heart attacks or strokes. Longer studies are needed to determine whether these improvements lead to fewer cardiovascular events.

The exercise program was also partly supervised, which may make it difficult to reproduce the same level of adherence in everyday life.

Conclusion: Exercise Remains Essential for Cardiovascular Health

The S-LiTE trial analysis provides new evidence that exercise plays a major role in protecting cardiovascular health during weight loss maintenance.

While liraglutide can support weight management, exercise appears to provide unique benefits by reducing inflammation and improving vascular health. For people with obesity working to protect their long-term health, combining medical treatment with consistent physical activity may offer the greatest benefits.

The message from this research is clear: maintaining movement after weight loss is not only about preventing weight regain. It may also help protect the heart, arteries, and overall health.

Source

Sandsdal RM, Holt J, Alkhefagie HGA, et al. “Effects of exercise and liraglutide on vascular health and inflammation during weight loss maintenance: a prespecified secondary analysis of the S-LiTE trial.” Nature Metabolism. Published 24 June 2026.

Disclaimer

This article is for informational and educational purposes only. It is not medical advice and should not replace guidance from a qualified healthcare professional. People considering weight loss medication, exercise programs, or changes to their treatment plan should discuss their options with a doctor or healthcare provider.